The National Council of State Board of Nursing (NCSBN) first presented the alternative format items to the boards of nursing in 1999 in order to continuously identify better and more effective ways to assess entry-level nursing competence. Since then, the NCLEX exams have a significant quantity of alternate format questions other than the usual multiple-choice questions.

Of these new types, one that many test candidates fear most is the dreaded “Select all that apply” or “SATA” type of questions. Most students fear this as they are unaware how to tackle them. Additionally, an examinee does not get credit for the entire question if not all possible right answers were selected, thus adding more frustration on these type of questions.

With that, here are some tried and true strategies and tips on how candidates can successfully answer these SATA questions.

1. Know the material

Do your homework and get to know as much nursing content as possible. Note that there are no shortcuts in preparing for the SATA questions and you need to be prepared and well reviewed about the topic.

2. Anticipate

Anticipate that there will be SATA questions during your exam. Doing so will help minimize your anxiety as these type of questions show up.

3. Remove frustrations

Most candidates get frustrated on the thought that one does not get credit for the entire question if not all the possible right answers were selected. Remove your prejudices about SATA questions and…

4. Take it positively!

SATA questions reflect the quantity and quality of your knowledge. These questions are added to the NCLEX question bank because in one question, the test can evaluate how well the candidate knows the topic. And in NCLEX’s Computer Adaptive Testing, if a difficult question (like SATA) shows up, it means you’re on a higher level of question and the right track!

5. Fully understand what the question is asking

Just like with any other formats, understand what the question is asking first. Train yourself to actually spend more time looking and processing the question that looking over the options. This is important so you’ll have a clear goal in mind before you proceed with comparing each options against your goal.

6. Tackle one by one

Here’s the secret to SATA questions: they’re actually a form of “true or false” type of questions! Therefore you proceed to answer each option by responding either with a “yes” or a “no,” if it “applies,” or “does not apply” to what the question is asking. Go down the list one by one and ask yourself if its a correct answer, then look at the next choice and do the same thing.

Here’s an example to try yourself:

Question: A nurse is caring for a pregnant client with severe preeclampsia who is receiving IV magnesium sulfate. Select all nursing interventions that apply in the care for the client.

1. Monitor maternal vital signs every 2 hours
2. Notify the physician if respirations are less than 18 per minute.
3. Monitor renal function and cardiac function closely
4. Keep calcium gluconate on hand in case of a magnesium sulfate overdose
5. Monitor deep tendon reflexes hourly
6. Monitor I and O’s hourly
7. Notify the physician if urinary output is less than 30 ml per hour.

If you isolate each choice to its own and selected it if it applies to the question, then you’ll end up choosing options: 3, 4, 5, 6, and 7.

Here’s the rationale for the question:

When caring for a client receiving magnesium sulfate therapy, the nurse would monitor maternal vital signs, especially respirations, every 30-60 minutes and notify the physician if respirations are less than 12, because this would indicate respiratory depression. Calcium gluconate is kept on hand in case of magnesium sulfate overdose, because calcium gluconate is the antidote for magnesium sulfate toxicity. Deep tendon reflexes are assessed hourly. Cardiac and renal function is monitored closely. The urine output should be maintained at 30 ml per hour because the medication is eliminated through the kidneys.

7. Don’t group choices

Treat each choice as a possible answer separate to the other choices. Don’t group or link the choices to one another and should not be answered as a group.

8. Pay attention to the options

Watch out for absolutes or extremes (e.g., at all times, all the time, complete restriction) as these are probably wrong choices. If you cannot recall the information or if it doesn’t make sense, it’s probably wrong.

9. Don’t over think

After you’ve chosen your answers by following step (tackle one by one), do not go back to change your answer. Most SATA questions are not on the application or analysis level type of questions, so it usually does not need you to factor in anything and modify your response. Do not change your answer unless there is something really obvious you’ve overlooked (i.e., the question looks for a negative response).

10. Minimum of two

According to the NCSBN site, there will always be more than one correct answer so a “minimum of two correct options.” It’s also rare to have all choices correct but it can technically happen. NCSBN requires the candidate to utilize their comprehensive knowledge to determine the appropriate amount of applicable maximum correct answers to each item.

11. Move on

If you tried the tips above and still can’t find the answer, you’re just wasting time and move on. Don’t let your “momentum” stop just because of a single question.

12. Practice

And to really prepare for the SATA questions, you need to get your hands dirty and try out answering these type of questions. Check out our 1500+ item NCLEX questions. And of course, our Select All That Apply (SATA) NCLEX Questions.


Have any more tips to share? Write what you have to say on the comments section below!


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