Hemorrhage is a potential complication that can occur within the first 24 hours after a percutaneous liver biopsy.

1. Test-Taking Strategies 2009 Workshop

2. Overview
• Essentials
• Objective Tests
– Question structure
• Question Types
– Multiple Choice & True/False
• Distracters & Limiters
– Matching
• Subjective Tests
– Process-orientated
– Fill in the Blank
• Short/Long Answer (Essay)
– Nursing (NCLEX) Processes
• Strategies & Learning Styles

3. Sound Advice…
Strategies alone
will not help you
•Instructors
Success areas all •Study skills: note-taking, text-book reading,
concentration
add up: •Time management
•Motivation
•NOT punishment or negative reinforcement
Positive thinking: •See it as: a tool for feedback , and how well your
learning strategies are working!
•A chance to show off 
“Skill” and “Will”

4. Essentials
Skim over entire test first before answering
Write your name on every test page
Check essays for spelling and grammar
Answer the questions you know for sure first
Anticipate and watch your time
Ignore your classmates’ pace
Answer all questions
Write clearly
Ask professor about the test beforehand

5. Questions to Ask about the Test
What type of questions
will be on the test?
What does the test
cover?
Is there a study sheet?
Will there be a review
session?
Will there be any
special instructions?
• How long is the
test?

6. Test Types
• Objective Types: • Subjective Tests:
– Multiple choice – Short Answers
– True/False – Essays
– Matching – Process-orientated
– Complete the – Critical Thinking
sentence/fill-in-the- – Field experience
blank
• Only one possible answer
• Less “wrong” answers,
yet “better” answers.
• Only one best answer
• All test your ability to recall • Test your ability for
information recognition

7. Three (3) Parts of a Test Question
• Brief scenario providing necessary info for answering the
question
The Background • May provide framework for stem
statement
• Contains the specific problem or intent of the item
The Stem
• Possible answers
• Correct answers are the keyed responses and the others are
distracters; which can be correct, incorrect, or less correct
List of options answers provided to try to confuse the test taker

8. The Stem (examples)
• Five forms of a stem in questions
– Background statement stems
• A young woman arrived to the hospital in early labor.
– Question Form stems
• Which of the following signs is the best indicator of
early labor?
– Incomplete sentence (fill-in-blank) stems
• The best indicator that labor is early and progressing is
_______.

9. The Stem (examples) cont.
– Multiple multiple stems
• Which of the following is the best indicator that labor is
early and progressing….a), b), c), d) or e)?
– Negatives or Exception stems
• All of the following behaviors are typical of a woman in
early labor except:
– The word except directs you to behaviors not typical
• Which of the following is NOT true about diffusion?
– The word not directs you to a process not affiliated with
diffusion

10. Test-Taking Strategies 2009
MULTIPLE CHOICE

11. Multiple Choice: Distracters
…and the distracters
Greater the similarity (incorrect answers), the
between the correct answer.. greater the difficulty
• What is the capital of • What is the capital of
Michigan? Michigan?
– A. Grand Rapids – A. California
– B. Detroit – B. Iowa
– C. Lansing – C. Lansing
– D. Ann Arbor – D. Montana

12. Multiple Choice • Which of the following is
– Distracters: NOT a form of potential
Don’t choose "All of the energy?
above" if any distracter is
false – A) sugar and carbohydrates
– B) fat compounds
– C) a solute gradient
– D) a muscle contracting
– E) all of the previous are
potential energy

13. Multiple Choice • If phagocytosis can be
– Distracters: compared to cellular
Don’t choose "None eating, then pinocytosis
of the above" if any
distracter is true can be compared to
– A) cellular elimination
– B) cellular drinking
– C) cellular dehydration
– D) none of the previous

14. Multiple Choice • The Following items are
– Distracters: part of culture:
Two or more – A) an automobile
distracters correct
choose “All of the – B) norms
above”
– C) language
– D) all of the above

15. The cell:
Multiple Choice a) is the fundamental unit of all living things
– Distracters: b) is very susceptible to disease when
A positive choice drinking alcohol
more likely to be true c) is not visible to the human eye
than a negative one d) is the building block only for DNA

16. • During cellular respiration, electrons move
Multiple Choice through a series of electron-carrier
– Distracters: molecules. Which of the following is a true
statement about this process?
•Correct answer / – A) The electrons move from carriers that have
more affinity for them to carriers that have less
choice with the most affinity for them.
information – B) The electrons release large amounts of energy
each time they are transferred
– C) Molecular oxygen is eventually oxidized by the
electrons to form water
– D) The carrier molecules are found in the
cytoplasm of eukaryotic and prokaryotic cells
– E) None of the statements are true.

17. Sequential Multiple Choice
• The following people were the founders of sociology; the author of Society in
America ignored due to her genders; the person who coined the term “ survival
of the fittest” and thought helping the poor was wrong; the sociologist who
studied social integration and suicide, and the sociologist who studied the
relationship between religion and capitalism.
– A) Comte, Martineau, Durkheim, Marx, Martineau
– B) Weber, Marx, Durkheim, Dubois, Weber
– C) Comte, Martineau, Spencer, Durkheim, Weber
– D) Comte, Spencer, Marx, Durkheim, Weber
– E) Comte, Addams, Durkheim, Weber, Martineau
• Answers are presented within the sentence and
separated by semicolons (;)
• Tip: Number the sequenced sentences in the
question, and match them with the answers.

18. Test-Taking Strategies 2009
TRUE/FALSE

19. Qualifiers
• DISTRACTERS Change the
choices and context found • LIMITERS Change the choice
in most answers and context found in most
questions

20. Multiple Choice & • True of False?
– Time can always be controlled
True/False Limiters – Everyone has the same amount
Absolute limiters are words that of time
turn sentences into extremes or
present inflexible circumstances – Prioritizing is a technique that
Absolute limiters are rarely identifies what is most
correct, especially in soft important
sciences, and usually be
eliminated as an answer choice
Negations:
“NOT”
“NEVER”
Absolutes:
“ONLY”
“ALL”
“EVERY”
“ALWAYS”
Choices/Degrees:
“BEST, MOST”
“WORST”
“EITHER/OR”

21. True/False • Pale, cool, and clammy skin suggests which
Question Limiters: of the following?
Likelihood – A) a stable patient
Some limiters are words that are – B) airway obstruction
meant to increase the likelihood that
the statement is true
– C) liver disease
“MOST LIKELY” – D) Shock
“BEST”
• If any part of the statement is false, then
“SUGGESTS, SUGGESTING,
SUGGESTIVE” the entire statement is considered false:
“SHOULD” – T/F: The sky is never blue
Some limiters ask for a degree of
possibility – T/F: The sky is blue everyday
– T/F: The sky is blue at _____ o’ clock
“MOST COMMON”
“…OF CHOICE”
– T/F: The sky is blue probably due to
“LEAST/MOST RELIABLE” oxygen
“MIGHT EXPLAIN”
“COULD HAPPEN”
“PROBABLY DUE TO: ”

22. (T/F likelihood cont.)
• T / F: You have checked your patient’s skin
temperature and have determined that
his/her forehead feels very cool. You should
now check the skin temperature in a more
central location such as the torso.
• Where is the limiter?
• When in doubt, choose “True”!

23. Test-Taking Strategies 2009
MATCHING

24. Matching
•Essentially are lots of
multiple choice questions
rolled together
•Correct answer for one
concept serves as a
distracter for all the others
•Strategies:
•Mixed flash cards with similar
definitions
•Diagramming old and new
information together
•Discuss similarities and
differences of concepts

25. Matching Question Steps
• First, read through each column
Question or Answer or
• Match the easiest items first
• Lightly cross out or check off an
Word Definition of
item as it is matched Word
• Determine multiple possible
answers
1). Listening A)Open-
• Use the process of elimination to minded
match difficult or unknown 2). Objective B) Prejudging
information
• Leave no questions blank if there
is no penalty for guessing 3). Obstacle C) Automatic

26. Test-Taking Strategies 2009
PROCESS-ORIENTATED QUESTIONS

27. Process-Orientated Questions
• Are designed to:
– describe a total step-by-step sequence of events
– identify the next best step possible within a sequence
– Test your knowledge for application in the real world
• What is the protocol for receiving an HBV vaccination?
– (Answer should start like) It’s a 3 step process…the first
step is…
• Name 2 extra steps used in blood culture specimen
collection that are not part of regular venipuncture
procedures?
– (Answer should start like) Two extra steps directly
following would be…1)…
• Anticipate questions, and study past the answer.

28. Process-Orientated Questions
(cont.)
• The LPN/LVN delivers external cardiac compressions to a client while performing
cardiopulmonary resuscitation (CPR). Which of the following actions by the
LPN/LVN is BEST?
– A) Maintain a position close to the client’s side with the nurse’s knees apart
– B) Maintain vertical pressure on the client’s chest through the heel of the
nurse’s hand.
– C) Re-check the nurse’s hand position after every 10 chest compressions
– D) Check for a return of the client’s pulse after every 8 breaths by the nurse.
• Look for key words
– First, primarily, initial, early, most important, except, next,
• The very next sentence answer should describe the very next step in the
process, - period.
– Place a period at the end of the test question
– Think of the very next step if you were to conduct this process in real
life

29. Process-Orientated Strategies
 Study prefixes, suffixes, and root words:
 Ex: A way to remember the difference between catabolism
and anabolism is…CATAstrophe is when everything starts
to break apart, and a body-builder on ANAbolic steriods
builds up more muscle.
 Study Greek and Latin roots of words
 When drawing a blood culture with the Winged
Infusion set (butterfly) always:
 draw the aerobic (AERO – air, mist, wind) first
 and draw the anaerobic bottle second (ANA – build up, back
again, throughout, against).
 When drawing a blood culture with a syringe always:
 draw the anaerobic bottle first
 Draw the aerobic bottle second.

30. Test-Taking Strategies 2009
FILL IN THE BLANK & SHORT/LONG
ANSWER (ESSAY)

31. Fill in the Blank vs. Short/Long
Answer
Fill in the Blank Short/Long Answer (Essay)
• Background Sentences • Sentences may/may not
provide memory cues for provide memory cues for
answers answers
• Requires recognition w/o • Requires recognition w/o
keywords present keywords present
(sometimes) (sometimes)
• Definitional FTB: require • Require to define, use, and
you to define the term, or explain concepts using
provide a definition in a sentences that belong
sentence together

32. Short Answer Questions
Points to consider Strategies
 If you cannot answer, move • (Studying) Define the word,
on to the next one. then reword the definition’s
 Look for questions with sentence into the form of a
concepts and answers that question
are similar for clues to other
questions • Study for relationships of
 Another question might concepts, not just definitions
trigger the answer • (Test-taking) Read the
 If you don't know--come question and try to answer it
back & make educated before reading the choices
guess if you must • If you are given choices to
 No blanks—guess and go for write on, read them all before
partial credit selecting

33. Short Answer/FTB Essentials
• (FTB) Generate your own questions from your notes, and challenge
yourself providing multiple answers
• Flash cards: Cornell style (your own words & book definition)
• Never assume that the length of the blank has anything to do with
the length of the answer
• Look for key words in the sentence that may trigger a response
– “According to…(scientist/practitioner/book author)”
– “(Company/individual/researcher/etc.) has decided to….”
• According to Henslin, sociology developed:
– A) in classical Greece and grew in Ancient Rome
– B) in ancient Rome
– C) during the social upheaval of the 19th century
– D) during the mid-20th century

34. Essay Questions: Keyword
Strategies
Key Word(s) Strategy
• Identify concept,, review
• 1) Apply >>>>>>>>>>>>>>>
case studies & scenarios
• 2) Integrate, relate, explain
• Explore relationships,
relationships, etc. >>>>>>>>
similarities/differences, &
use mind maps.
• 3) Analyze,
compare/contrast, defend,
• Critical analysis of all of the
describe, etc. >>>>>>>>>>>
above! Rehearse and/or
Explain to someone for
clarity!

35. Long Answer (Essay) Strategies
• Plan your time
• Read through the entire question
• Pay attention to key words:
– Describe; differentiate; explain, give an example; compare
and contrast
• Develop an outline so you know what to include in
the answer:
– Write down keywords in the margins as you think of them
– Your opening statement summarizes your essay
– Summarize and conclude your thoughts again in your final
paragraph
– Take time at the end to reread your answer!!

36. Test-Taking Strategies 2009
NURSING (NCLEX) PROCESSES

37. Nursing Study Outline Strategy
1) Outline your notes to each disease
a) With info from lecture and book
2) Study Nursing Learning Objectives
3) Pathophysiology of disease/system
4) Assessment of Signs and symptoms (including tabs)
a) Subjective Data & Objective Data
b) Highlight special S & S
i. Such as RLQ pain for appy
5) Nursing Diagnosis
6) Goals:
a) Intervention, prevention, alleviate symptoms
b) Promote physical and emotional rest
c) Health teaching
7) Specific Implementation Plans
8) Evaluation/outcome criteria (normalness)

38. Test-taking Strategies cont.
• Reword the Question:
Ex: Which of the following is a complication that occurs during the
First 24 hours after a percutaneous liver biopsy?
a) Nausea and vomiting
b) Constipation
c) Hemorrhage
d) Pain at the biopsy site
• The question restated is “What is a common complication of a
Liver biopsy?”
• The question restated at a higher level (application) is “Which is
Best indicator of hemorrhage?”

39. Nursing Strategies (cont.)
• Think physiological needs first…
– Airway
– Breathing
– Circulation
– Disability
• Safety second
• Communication
• Nursing process:
– 1) Data Collection
– 2) Planning
– 3) Implementation
– 4) Evaluation

40. Learning Style Strategies
• Linguistic/Verbal/Intrapersonal Learners:
– TRY TO ANSWER QUESTION(S) YOURSELF OUT LOUD
– Turn the chapter/lecture objectives into questions
– Make a sample question for each key word written or
described in the lecture
– Use word associations:
• If you rank 51 tests and get the 26th highest score, that’s the ______. If
you take the most common score or scores, that’s the ______. If you add
all of the scores and divide by the number of tests, that’s the ________.
– A) mean, median, mode mode (most),
– B) median, mode, mean median (middle, just above middle)
– C) median, mean, mode >>>>>>>>>>>>>>> mean (‘average’..”you’re mean if you call
– D) mode, mean, median me average!”)

41. Learning Style Strategies
• Visual Learners:
– Utilize Youtube, CD-
Roms with textbook,
DVDs, labs, & your
textbook’s websites
– Draw or use pictures and
diagrams
– Visualize test questions,
and visualize the answer
being applied

42. Learning Style Strategies
• Interpersonal/Kinetic/Visual Learners:
– Walk and talk to yourself while reading the book
– Find a serious study partner to discuss Q & A.
– Use a study room with a dry erase board
– Try to teach yourself and your study partner using
the dry erase board
– Utilize any open lab time and find manipulative,
(models), or hands-on parts to work with

43. Study Strategies (cont.)
• Visualize the test question, then picture yourself applying the
procedure or going through each action given in each answer
• Use practice exam workbooks with answers
• Form sample test questions for each bolded term in the book,
and for each keyword said by the instructor
• Take sample tests over and over until we get perfect scores
• Use all resources (DVD, CD-Rom, online crosswords, flip cards,
Note cards, posters/pictures, etc.

44. Commonly misunderstood
Strategies
 Don't change your answer*
– You more often remember the times when
changing your answer cost you points, and less
often remember the times when changing it
gained you points
– Geiger’s (1991)* study showed…
– Go with what you believe is correct – first choice
or if you go back
• Sound Advice

45. Interactive Websites
• Nursing Practice test websites
– http://caring4you.net/tests.html
– http://www.nurseshift.com/nclex_study_guide.aspx
– http://www.testprepreview.com/modules/nclex.htm
– http://www.slideshare.net/nclexvideos/studyskills-ii
• Biology
– http://www.webanatomy.com
– http://highered.mcgraw-hill.com/sites/dl/free/0072437316/120060/ravenanimation.html
– http://nhscience.lonestar.edu/bioL/animatio.htm#geology
– http://www.execulink.com/~ekimmel/
– http://www.wiley.com/legacy/college/boyer/0470003790/animations/animations.htm
– http://www.nlm.nih.gov/medlineplus/tutorials.html
– http://media.pearsoncmg.com/bc/bc_marieb_ehap_8/activities/index.html
– http://telstar.ote.cmu.edu/biology/animation/
• EMS/EMT
– http://id44.com/
– http://www.id44.com/general%20EMT%20preparation%20exam%20id44.html
– http://smartmedic.com/quiz/index.asp
– http://www.geocities.com/nyerrn/ems/tests.htm