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The Parts of a Question
The question contains several parts:
o the case
(sometimes called scenario) - the description of the client and what is
happening to him/her
o the stem - the part of the question that asks the question
o the correct response
o distracters - incorrect but feasible choices
Key Words
The most
important skill for the test taker is the ability to read the question carefully
and determine the key elements in each question. Each question has key words.
Key words relate to the client; to the problem; and to specific aspects
of the problem.
Client
Factors
such as age, sex, and marital status may be relevant. When a child's age
is given it often is very relevant to the answer. Vital signs vary with
age. Preoperative teaching methods vary with age. Appropriate toys and diversional
activities vary with age. Always pay special attention to the age of a client
when it is given. Also consider who is the client for this question. That
is, who is the focus of the question. The client may be the identified sick
person, or it might be a relative of the identified sick person, or even
a staff member.
Problem/Behavior
The problem may
be a disease, a symptom or a behavior.
Details of the
Problem
o Is
the question asking for nursing actions or client symptoms or family responses?
o Does the question
ask about a specific aspect of nursing care assessment, planning, implementation,
evaluation?
o Does the question ask details relevant to a specific symptom or behavior
the client exhibits?
o Is there additional information about the client or the problem that is
important?
Priority Setting
o "What action
takes priority?"
o "What should the nurse do first?"
o "What should the nurse do initially?"
o "What is essential for the nurse to do?"
Physiologic needs are first, followed by safety needs, then love and belonging, self-esteem and self-actualization.
The first step of the nursing process is assessment! When the stem of a question asks for the initial nursing action always look to see if there is a relevant assessment answer. The nurse will take an action only when there is enough data to act. Call the physician only when there is not a nursing action that should be taken first. The stem of the question may ask for a nursing action and the correct answer may be to assess.
When the stem of the question asks what is essential for the nurse to do, think safety. Remember many of the test questions are safety questions.
What is the Time
Frame?
Whenever a specific time frame is indicated in a question it is very important.
Pay attention to it. Time related words may be like early or late in relation
in symptoms, pre operative or post operative, care on the day of surgery
or later postoperative care.
Repeated Words
Words from the question are repeated in the answer. Frequently the same
word or a synonym will be in both the question and the answer.
Opposites
When two answers are opposite such as high blood pressure and low blood
pressure or increase the drip rate and stop the IV, or turn on the right
side and turn on the left side, the answer is usually one of the two.
Same Answer
If two or three answers say the same thing in different words none can be
correct. If the answers are too alike, then neither one is correct.
Odd Answer Wins
The answer that is different from the others is apt to be the correct answer.
It may be the longest or the shortest or simply very different in content
or style.
Umbrella Answer
One answer includes the others. There may be more than one correct answer.
One answer is better than all the others because it includes them.
Test Item Check List
Use this handy list to check yourself every time you answer a test question.
Say to yourself, DID I CAREFULLY...
o Read the stem?
o Read all of the options?
o Read the stem again?
o Look for key words?
o Eliminate obviously incorrect options?
Absolutes
Answers containing universal or absolute words are very apt to be incorrect.
Very little in life or nursing is always correct or incorrect. Answers stated
in absolute terms should be looked at with great caution.
Deadly
- all
- every
- total
- nothing
- always
- each
- only
- any
- nobody
- never
- none
Dangerous
- main
- chief
- avoid
- primarily
- major
- shall
- inevitable
- eliminate
- rarely
- impossible
- too
Safe
- usually
- almost
- frequently
- probably
- potentially
- may
- sometimes
- partial
- some
- might
- should
- few
- essentially
- generally
- occasionally
- nearly
- maybe
- could
- commonly
- average
- seldom
- often
- normally


