After reading the tips, look I'm now smiling my way through this test!

Before you step into the real world of nursing, you must pass their licensure examination first to prove that you’re a safe and effective nurse! Reviewing board exam questions are just a way of further enhancing your knowledge and confidence for one of the most important test in your life. What you must remember is that you are already knowledgeable about cores of nursing, but this knowledge would be futile if you cannot apply effective test-taking skills during your exams. You have a substantial amount of knowledge about nursing, but how do you really know how to use this knowledge during exams?

Researches suggest that an examiner who fully understands test construction and familiar with appropriate test-taking strategies score higher than those with similar level of knowledge but with inadequate test-taking skills.

Multiple choice tests are different from tests such as essays, identifications and true/false. In multiple choice exams, the question is called the stem. The stem is followed by four alternative answers. One answer is correct, and the other three are called distracter because they distract your attention from identifying the correct answer. Note also that these distracter are not necessarily incorrect answers but rather they may not be as correct as as the one you are required to choose.

Here we have 10 effective test-taking skills and strategies that can help you during your examinations:

1. Extra meaning need not apply!

Test questions are made to be direct and to the point so you don’t need to read extra meaning to the question. The question asks for one particular response and you should not read or add other information into the question.

Often you will find questions that require “common sense” answers and that reading into these questions may give you another interpretation. You should not search for subtle meaning about the questions or answers.

Ask yourself “What is the question asking?” Look for keywords and phrases to help you understand. Interpret the question correctly first before reading into the choices.

2. Understand the question

Make sure you read the stem correctly and notice particularly the way the question is phrased. Is it asking for the best response or the initial response? Understand what the question is asking before considering the distracter.

3. Rephrase

Rephrasing technique requires you to interpret or translate the question into your own words so that it is very clear in your own mind. Rephrasing the stem of the question can assist your read the question correctly and in turn choose the appropriate response.

Placing the question into your own words would help you in removing extraneous data and get into the core of the stem.

4. Isolate

When analyzing the distracter, isolate what is important in the answer alternatives from what is not important relative to the question. In a good test construction, all of the distracter should be feasible and reasonable, and should apply directly to the stem. There should be a commonality in all of the distracter.

Also, all of the distracter may be correct but not the right choice for the specific question that is being asked. The technique here is to ask yourself whether each possible alternative is true or false in relation to the stem.

5. Recheck

Many test-takers fail to recheck the answer with the stem, and they answer the question incorrectly. After choosing the correct answer alternative and separating it from the distracter, go back to the stem and make sure your choice does, in fact, answer the question.

An effective strategy is to judge all four alternative choices/options against the stem and not against one another. Read the stem, then check option 1 against the stem, then check option 2 against the stem and so on. This process will eliminate choosing an alternative that does not fit with the question.

6. Process of Elimination

When a question contains multiple variables as alternative choices, use the “elimination of variable” technique. Each question may pose different alternatives with several variables. Use the process of elimination.

Study the question first and ask yourself what variable fits with this condition, or after examining the distracter underline the symptom that you know is correct. Now ask yourself what variable is not present with this condition. Again examine the distracter and cross out those variables that are incorrect. By this process you’ve probably eliminated at least two distracter even without taking the time to consider the other two.

7. Go back to the basics

When you come across a difficult question and you cannot immediately identify the answer, go back to your body of knowledge and draw all the information that you do know about the condition. Don’t start being anxious and especially don’t panic!

If you are unfamiliar with the disease or disorder and cannot choose the right nursing action, try to generalize to other situations. For example, if the question asks about dog bites, and you’ve never learned the course of the disorder, go back to an area of knowledge that you do know, for example, circulation and body response to toxic substances.

Even though you do not know exactly what to do, you might know what not to do. Eliminate distracter to increase your chances of arriving at the correct answer.

8. Educated guesses

The ability to guess correctly is both a skill and an art.

The board exams is not a “right minus wrong” type. It is important for you to answer every question even if you have to guess. Guessing gives you only a 25% chance of getting the correct answer.

Try to eliminate at least one (or more) distracter as this will increase the percentage margin of chance for guessing correctly.

Examine the distracter and if one is the exact opposite of another (e.g. complete bed rest is different from activity as tolerated; both cannot be correct since they are of opposites), choose the one that seems to be most logical.

Try to identify the underlying principle that supports the question. If you can answer the question, you might then be able to guess the correct answer. This strategy is especially true with a psychosocial question.

Look at the way the alternatives are presented. Are there two answers that are very close? Often when this occurs, the ability to discriminate will show evidence of judgement. Check to see if one, more than the other, is the best choice for the question.

Are there any distracter that are presented not logical (which are correct in themselves but do not have anything to do with the question)? Eliminate these and focus on other alternatives.

Use your intuition. If you cannot choose an alternative from a logical point, allow yourself to feel which one might be right. Often your subconscious mind will choose correctly (based on all the conscious knowledge you have of course) so simply let yourself feel which alternative might be right. Remember, its better to choose one answer than none at all.

9. Choosing answer from a hunch

There comes a time when you are faced with a certain question and you have a hunch that this particular choice is correct. Do we depend on this “hunch?”. Current studies supports that hunches are often correct, for they are based on rapid subconscious connections in the brain.

Your stored knowledge, recall, and experience can combine to assist you in arriving at the correct answer. So, if you have an initial hunch, go with it! Do not change the answer if and only if, upon reflection, it just doesn’t seem right. On the other hand, if later in the test you find relevant information or make new connection of information and you feel that your answer was incorrect, do go back and change it.

10. Choosing the best answer from a strategy point-of-view.

Frequently, the most comprehensive answer is the best choice (Longest the best!). For example, if two alternatives seems reasonable but one answer includes the other (i.e., it is more detailed, more comprehensive), than this answer would be the best choice. If an answer focuses on medical knowledge, be wary, for this alternative might be just a good distractor. Remember, this is a nursing test and questions are designed to test your nursing competency and safety.

It is unlikely that a question would require a medical action for the correct answer; it may, however offer these actions as distracter.


Beware of answers that contain specific qualifiers, such as “always’ and “never,” they rarely fit within a logical framework.

Did we miss anything? Share you own tips and strategies at the comments section below!

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