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Thursday, January 20, 2011

The Infamous Nursing Exam

If you're in nursing school, you know why I call the nursing exam 'infamous'. Nursing exams are infamous for being tricky and tough. But that's the point. Your patients will be tricky and tough! Nursing exams are there so your instructors can get you prepared for critical thinking on the job, when you're in a tight spot, and you have no supplies. So how do you tackle a nursing exam and come out alive? I have a few tips that may save you a few heart attacks, mental breakdowns, and depression.

Don't Fall Down on Your Reading and Studying

Don't ever let yourself get behind on reading and studying. The instructor will give you the MOST important information in class, but you can (and will) be tested over material that was in your reading assignment. Why? Because there is absolutely no way your instructor can cover every single detail in class. If she were expected to, classes would last forever, and you'd be in nursing school for years and years and years.  So block some time into your calendar just for reading and studying. Make sure you spend 3 hours x the credit hours for that course in reading and studying each week. So if you are taking a course that is worth 5 credit hours, multiply 5 x 3 hours, and you get 15 hours you need to study for that one course.

Study Your Notes Immediately

Take good notes during class. Make spelling errors, make them sloppy, make up abbreviations that you will understand. But...if you don't read those notes again until a week later, you won't know what you were writing about! Once you are done with class, go home or to a study area immediately. Pull out your notes and your textbooks. Rewrite your notes legibly and so you can read them and understand what they mean. Use your textbook to fill in information that your instructor didn't talk about in class. So, you covered hanging IV fluids in class, but the book says you have to check Y-site compatibility before you hang any medications with the primary fluids. Write that down in your notes. You will come away having already studied AND you have a more thorough idea of the concepts covered during class.

Take Care of Yourself

The night before the exam, DON'T CRAM. That is almost everyone's first instinct. Yes, read over material but don't cram so much info into your mind that you lose most of it. Your brain takes time to convert short term memory into long term memory. If you don't know something the night before the exam, chances are you won't know it for the test. Allow yourself time for plenty of rest. Eat well. Relax. Wake up early so that you can eat a good breakfast. Don't overdo it on the caffeine. One cup of coffee or soda - MAX. Don't try the energy drinks. Too much caffeine will make you nervous, jittery, less alert, and even nauseated. You wouldn't want a surgeon coming to do your surgery in that condition...so don't take a test in that condition. Lay everything out the night before that you will need. You might need a pencil, an ID badge, or other supplies. Put everything next to your keys and bag. Even get your clothes ready the night before. This will cut down on the rushing around. Rushing around the morning of a test will only make you more nervous. Give yourself time and you will be much more relaxed. Make sure to arrive early enough that you won't be breathing hard when you get to your seat.

Stay Away From Negative Nancy

Nursing students are always nervous about tests. A career is on the line! But don't get sucked into a situation that will only cause you to freak out and send your B/P skyrocketing. I often see students huddled out in the hallway prior to a test, chewing their lips, saying, "I'm going to flunk this test! I should have studied that more. I didn't know about that! Were we supposed to study that???" These students only get others around them more worked up. If you are nervous and worked up, you won't concentrate as well. Let your friends know that you love them, but that you have to have quiet time before an exam. Then go find a quiet place away from everyone else until the test room doors open.

Take a Minute

Before you start your exam, listen to any instructions the teacher has for you. Listen carefully! Then, before you even look at the first question, put down your pencil, close your eyes, and take a slow, deep breath, in through your mouth. Then let it out slowly through your mouth. Tense up every single muscle in your body. Then relax your body from bottom to top, relaxing each muscle group in turn as you move up your body. When everything is relaxed, take in a few more deep, cleansing breaths. Open your eyes, pick up your pencil, and begin.

READ THE INSTRUCTIONS!

I have seen more students get questions wrong from not reading directions than anything. Follow the directions to the finest detail.

Read Each Question and Answer Thoroughly

Cover up all answers for the question you are reading. Read the question thoroughly. If you are allowed to write on your test, underline all the important words, such as BEST, MOST, FIRST, etc. Then read the question again to be sure you understand what it is asking. Is it really asking about the patient's breathing, or is it asking about the sputum? Cancer or therapeutic communication? Once you understand what the question is asking, formulate an answer in your head. Then uncover the first answer. If you think it could possibly be right, put a checkmark by it. If you know it's wrong, without a shadow of a doubt, but an X beside that answer. Do this for each answer, reading each one thoroughly. When you are done, look at what you have left. Do any answers match the answer you formulated without looking at the answers? If so, that is most likely the answer. If not, what would your second guess be for the answer? Is it listed below? If you can knock the correct answers down to two to choose from, which one is the MOST correct? Don't infer anything...EVER. Use ONLY the information supplied to you in the question. If you start developing 'what-if' scenarios, you will think much too deeply and end up getting the question wrong.

Trust Yourself

Most students go back over the exam and their answers if they have time (if it's a paper and pencil test...more on computerized testing later). The thing that kills me is that many times, a student may have had a correct answer the first time, but then erased it and changed it to the wrong answer. This happens because the student begins to panic and starts second-guessing him- or herself. Yes. Look over your answers. HOWEVER...DO NOT CHANGE YOUR ANSWER IF YOU UNDERSTOOD THE QUESTION THE FIRST TIME AROUND. If you read back over the question and realize it's asking something different from what you thought the first time you read it, THEN change your answer.

Make Pretty Dark Bubbles

If you use a ScanTron, make sure you bubble in your answers thoroughly. ScanTrons are graded by running them through a machine, and if a bubble isn't dark enough, or doesn't cover the circle all the way, the machine may overlook it and count it wrong. Don't make any stray marks on the ScanTron as that could also affect your grade. If you are using computerized testing, make sure you selected the answer you meant to select. Some electronic exams allow you to save each individual answer before moving on. If so, save your answers. If a glitch occurs and your exams goes away before you are finished, you do not want to have to work on questions you have already answered again.

Breathe a Sigh of Relief

Before you turn in your test (or hit the submit button), take some more deep breaths. Turn it in and either return to your seat or leave...whichever your teacher has instructed you to do. Don't worry about it any more. There's no going back once you have turned in your test. Worrying will not do one thing. So many people want to worry and worry and then worry some more. But honestly, what does that do? NOTHING! If you have to go back to your desk and wait, put your head down on your desk if that's permitted. Or get in a relaxed position. Don't look around at what others are doing. It will only heighten your anxiety. Meditate, do breathing exercises, relaxation exercises, or fix your stare on a dot on the wall. Whatever you do, just keep your mind off of the test until needed (if your school does test review, etc.).

Have Fun

If you have to wait on grades to be posted, don't sit around and think only about what your grade might be. Go have a little bit of fun. Go down to the lake or take a scenic route home. If you have to go to work that will also serve to keep your mind off of the test. Don't sit at home hitting refresh on your browser until grades are posted. Anxiety = elevated B/P. And there's  no use worrying about it at this point. What is done is done. At least enjoy the moments in your life that you are not using to take a test.

Future postings will discuss computerized testing and different learning styles. Knowing your learning style will help you tremendously when studying, so make sure you check back soon! And quit worrying about that test after you have taken it!

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