Review of Hemodialysis for Nurses and Dialysis Personnel, 8th Edition

Chapter 26. Test taking guidelines

Preparing to take any certification exam can produce a lot of anxiety. You may feel that the certification exam reflects all of the time and effort you’ve invested to be successful in your position. You may have already taken several steps to achieve success in your position and completed a specialty training program as preparation for your position, or you may have completed a review course in preparation for the certification exam. One method to achieve success is the development of a plan for preparation, dedicated study time, and increasing your knowledge and skills in test taking. When that has been accomplished, the next step is the development of a preparation plan to successfully pass the exam.

How do i develop a plan?

First review your previous experiences in successful test taking. Think about the plan you developed to study for a particular test. What part of the study plan worked most successfully for you? Did you study best alone or in a group? Did you successfully set specific times to study? Were you able to balance time for work and family obligations? Did you have a comfortable study place at home or at another quiet location? Now that you’ve reviewed your previous study plans, develop a plan for successful completion of the certification exam.

Begin by developing a schedule, using a calendar to plan your work schedule, family obligations, study times, and the date on which you will take the certification exam. Your calendar needs to include two to three hours of daily quality study time for at least two weeks prior to the day on which you plan to take the exam.

You may want to find a study partner or form a study group. Study groups work well if the group is small, about four to six members. It’s best to establish a ground rule that each member will come prepared to study and share knowledge.

What is quality study time?

Quality study time means uninterrupted daily quiet time spent studying for the certification exam. It involves finding a quiet and comfortable place at home or at another quiet location. Try to eliminate anything that may interrupt your study time; this includes turning off your pager and cell phone so you won’t be disturbed. Let people around you know about your study needs and the importance of your study plan for successful completion of the certification exam. Review your study plan daily and make adjustments to it if necessary.

It is also helpful to practice taking tests that are similar to the certification exam. For example, if you will be taking the exam online, practice using the online testing system. Review books commonly are accompanied by CD-ROMs, which provide practice test questions.

What is the best technique for answering multiple-choice questions?

Always carefully read the test directions. If the test is administered electronically, be sure you understand how to mark, change, and submit your answers. All multiple-choice questions have a scenario, which contains the essential information about the patient or situation. The question will also contain the stem or question followed by several choices or answers. You may be asked to choose the one best answer or to choose all answers that apply.

How do i select the best answer?

To select the best answer to a multiple-choice question, focus only on the information in the question. Avoid reading into the question or asking “what if?” The question provides all of the information necessary to choose the correct answer. Look for strategic words in the question, including immediate, initial, priority, side effect. These words give an indication to the answer (Box 26-1).

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Box 26-1 Practice Question: Strategic Words

Mrs. K. arrives for her hemodialysis treatment complaining of flulike symptoms and says she has been vomiting. Which of the following laboratory values should be reported immediately to the physician?

1. Sodium, 148 mEq/L

2. Chloride, 102 mEq/L

3. Potassium, 3.2 mEq/L

4. Bicarbonate, 27 mEq/L

Correct choice: 3

Test taking skill: The strategic word immediately indicates that one of the choices will contain an abnormal laboratory value that should be reported to the physician. Normal potassium is 3.5 to 5.0 mEq/L. A value of 3.2 is below the normal value and should be reported immediately.

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Always read the question twice and come up with the answer in your head. Then read all of the choices before you select an answer. Don’t make the mistake of choosing an answer too quickly. Use the process of elimination and discard the answers you know are not correct. When you have eliminated choices, reread the question before selecting your final answer. Don’t keep changing your answer; your first choice is usually correct, unless you misread the question. Remember not to second-guess yourself.

How do i eliminate wrong choices?

Be aware of keywords that indicate a wrong choice. Absolute words, such as never, always, only, all, and any, are too broad and commonly indicate a wrong choice. If you cannot answer a question quickly or use logic to eliminate a wrong choice, move on to the next question and forget about the previous question. Most certification tests have a time limit. Don’t use your valuable time trying to solve difficult questions or ones you cannot answer logically (Box 26-2).

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Box 26-2 Practice Question: Absolute Words

Ms. S., a college professor, is diagnosed with polycystic kidney disease. She requests information about the pathophysiology of her disease. Which of the following statements is correct about adult polycystic kidney disease?

1. The kidneys can become markedly enlarged.

2. Deterioration of renal function is always rapid.

3. It is an immune-related disease.

4. Only invasive radiology tests can diagnosis this disease.

Correct choice: 1

Test taking skill: Adult polycystic kidney disease results in outpouching or distention of the wall, resulting in an enlarged kidney. Choices 2 and 4 contain absolute words and indicate wrong choices.

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What if the test includes true-false items?

If the test includes true-false items, carefully read through each statement and pay attention to the qualifiers and keywords. Such qualifiers as usually, sometimes, and generally mean that the statement may be true or false depending on the information provided in the statement. It is common for these types of qualifiers to indicate a true answer. If any part of the statement is false, then the entire statement is false (Box 26-3).

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Box 26-3 Practice Question: True-False Items

Sodium polystyrene sulfonate (Kayexalate) is generally used in the treatment of hyperkalemia and is an effective treatment for severe hyperkalemia.

1. True

2. False

Correct choice: 2

Test taking skill: The first part of the statement is true, as Kayexalate is generally used in the treatment of hyperkalemia. However, it is not an effective method for treating severe hyperkalemia. Thus the second part of the statement is false, making the entire statement false.

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What if i have a question that requires prioritizing?

When you read the question’s scenario and stem, look for strategic words that indicate the need to prioritize. Common strategic words that indicate a need to prioritize include best, essential, first, immediate, initial, vital, most important, and most appropriate. Remember that when a question asks for the priority, all choices may be correct but you will need to determine which action should occur first (Box 26-4).

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Box 26-4 Practice Question: Prioritizing Items

A patient is experiencing an anaphylactic reaction to a new antibiotic. Which of the following actions should be implemented immediately?

1. Maintaining a patent airway

2. Administering a corticosteroid

3. Administering epinephrine (Adrenalin)

4. Instructing the patient on the importance of obtaining a MedicAlert bracelet

Correct choice: 1

Test taking skill: All of the choices should be implemented, but the ABC (airway, breathing, circulation) of emergency situations indicates that maintaining a patent airway is the priority and requires immediate action.

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How do i reduce my test taking anxiety?

Review your test plan to determine whether you provided enough time to prepare for the exam. If you did not, make adjustments to your plan.

A few days before the test, take some time to relax and recharge. If you must travel to a testing center, you may want to take a test run to the center so you will feel confident about the travel time needed and not feel anxious about arriving late for the exam.

On the day before the exam get a good night’s sleep. Upon waking, follow your usual morning routine but do eat a nutritious meal before the test. It’s difficult to concentrate if your stomach is rumbling. Finally, before the test begins, go to the bathroom; it’s difficult to concentrate if you are uncomfortable.

During the exam, read the test directions slowly and carefully. Stay relaxed and use positive self-talk; if you begin to get nervous, breathe deeply, try smiling (which is relaxing), and then refocus on the test. Write down any important formulas or definitions on a piece of paper given to you at the exam. Remember that you most likely will not be allowed to bring calculators, cell phones, or notes into the testing area. Don’t worry about how quickly other people finish the exam; concentrate on your own exam. Give yourself positive feedback and remember your plan for success.



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