Testing Strategies

Your test taking toolkit

First: READ the entire Second: Use tools to

question! eliminate answer choices
1. What is this question really asking ● Opposites can’t attract
me?” ● Sneaky similarities
2. “Am I looking for ‘trues’ or ‘falses’?” ● Don’t know it? Don’t guess it.
3. Phrase the answer choices as true ● Least invasive > Most invasive
or false questions. ● Eliminate what you know is wrong
first.
● If part of the answer choice is
wrong, the whole answer is wrong.
● Do the work yourself.
● Listen to your client.
First: READ the entire question!
1. What is this question really asking me?”
a. Define EVERYTHING
b. Put it in your own words.
c. Highlight key words
2. “Am I looking for ‘trues’ or ‘falses’?”
3. Phrase the answer choices as true or false questions.
a. More than one choice
i. They could all be right…. Only one could be right!
b. Single Choice
i. Compare two answers at a time

*Tip: All NGN questions can be broken down into a question with more than one
choice or a question with a single choice. They just look different!*

First: READ the entire question!

1. “What is this question really asking me?”
a. Define EVERYTHING
b. Put it in your own words.
c. Highlight key words
NCLEX Question
A nurse is caring for a client receiving digoxin. The client’s most recent serum
digoxin level was 2.5 ng/mL. Which of the following essential nursing actions
should the nurse take? Select all that apply.

NCLEX Question
A nurse is caring for a client receiving digoxin. The client’s most recent serum
digoxin level was 2.5 ng/mL. Which of the following essential nursing actions
should the nurse take? Select all that apply.

Priority actions for digoxin toxicity.

First: READ the entire question!
1. ✅
2. “Am I looking for ‘trues’ or ‘falses’?”
a. True:
i. Demonstrates understanding
ii. Action I want to take
iii. Essential item
b. False:
i. Requires intervention
ii. Requires follow up
iii. Incorrect item
iv. Inessential item

NCLEX Question
A nurse is caring for a client receiving digoxin. The client’s most recent serum
digoxin level was 2.5 ng/mL. Which of the following essential nursing actions
should the nurse take? Select all that apply.
NCLEX Question
A nurse is caring for a client receiving digoxin. The client’s most recent serum
digoxin level was 2.5 ng/mL. Which of the following essential nursing actions
should the nurse take? Select all that apply.

True responses

First: READ the entire question!

1. ✅
2. ✅
3. Phrase the answer choices as true or false questions.
a. More than one choice
i. They could all be right…. Only one could be right!
b. Single Choice
i. Compare two answers at a time

*Tip: All NGN questions can be broken down into a question with more than one
choice or a question with a single choice. They just look different!*
NCLEX Question
A. Withhold the client’s scheduled dose
B. Administer the dose as prescribed
C. Assess the client's urinary output
D. Assess the client's most recent sodium level
E. Assess the client’s heart rate and rhythm

NCLEX Question
A. True or false - should I withhold the client’s scheduled dose?
B. True or false - should I administer the dose as prescribed?
C. True or false - should I assess the client's urinary output?
D. True or false - should I assess the client's most recent sodium level?
E. True or false - should I assess the client’s heart rate and rhythm?
First: READ the entire question!
1. What is this question really asking me?”
a. Define EVERYTHING
b. Put it in your own words.
c. Highlight key words
2. “Am I looking for ‘trues’ or ‘falses’?”
3. Phrase the answer choices as true or false questions.
a. More than one choice
i. They could all be right…. Only one could be right!
b. Single Choice
i. Compare two answers at a time

*Tip: All NGN questions can be broken down into a question with more than one
choice or a question with a single choice. They just look different!*

Second: Use tools to eliminate answer choices

● Eliminate what you know is wrong first.
● If part of the answer choice is wrong, the whole answer is wrong.
● Opposites can’t attract
● Sneaky similarities
● Don’t know it? Don’t guess it.
● Least invasive > Most invasive
● Do the work yourself.
● Listen to your client.
 Eliminate what you know is wrong first.
If you KNOW one of the answer choices is wrong - eliminate it from the get go!

→ Trust your gut. You DO know this material!

→ Take it one answer choice at a time.

→ SLOW DOWN!

You will have scrap paper/a white board during the exam. Jot down the
choices, and cross out the ones you KNOW are wrong!

NGN Question
History and Physical Orders
77-year-old male with a history of aplastic
anemia reports significant weakness, ▪ Admit to medical-surgical unit
dyspnea and dizziness that began two ▪ Hematology consultation
days ago. The client states that the ▪ Transfuse one unit of packed red
symptoms have progressively worsened. blood cells

The nurse is caring for a client with a history of aplastic anemia in the medical-surgical unit. Drag the words
from the choices below to fill in each blank in the following sentence.

Word Choices
The nurse plans to administer the units of blood with ____________. weigh the client
lactated ringers
Y-type tubing
Prior to the transfusion, the nurse should ______________. administer antiemetics
check vascular access patency
NGN Question
History and Physical Orders
77-year-old male with a history of aplastic
anemia reports significant weakness, ▪ Admit to medical-surgical unit
dyspnea and dizziness that began two ▪ Hematology consultation
days ago. The client states that the ▪ Transfuse one unit of packed red
symptoms have progressively worsened. blood cells

The nurse is caring for a client with a history of aplastic anemia in the medical-surgical unit. Drag the words
from the choices below to fill in each blank in the following sentence.

Word Choices
The nurse plans to administer the units of blood with ____________. weigh the client
lactated ringers
Y-type tubing
Prior to the transfusion, the nurse should ______________. administer antiemetics
check vascular access patency

NGN Question
History and Physical Orders
77-year-old male with a history of aplastic
anemia reports significant weakness, ▪ Admit to medical-surgical unit
dyspnea and dizziness that began two ▪ Hematology consultation
days ago. The client states that the ▪ Transfuse one unit of packed red
symptoms have progressively worsened. blood cells

The nurse is caring for a client with a history of aplastic anemia in the medical-surgical unit. Drag the words
from the choices below to fill in each blank in the following sentence.

Word Choices
The nurse plans to administer the units of blood with Y-type tubing. weigh the client
lactated ringers
Y-type tubing
Prior to the transfusion, the nurse should check vascular access patency. administer antiemetics
check vascular access patency
Second: Use tools to eliminate answer choices
● Eliminate what you know is wrong first.
● If part of the answer choice is wrong, the whole answer is wrong.
● Opposites can’t attract
● Sneaky similarities
● Don’t know it? Don’t guess it.
● Least invasive > Most invasive
● Do the work yourself.
● Listen to your client.

If part of the answer is wrong, the whole

answer is wrong.
If multiple symptoms, treatments, medications, etc. are listed in an answer
choice, they must ALL be correct for the answer choice to be correct.

Correct + Incorrect = incorrect!

NCLEX Question
A client suddenly develops syndrome of inappropriate antidiuretic hormone
(SIADH) after undergoing cranial surgery. Which manifestations should the
nurse expect to see from the client? Select all that apply.

a. Edema and weight gain

b. Decreased urine production
c. Hypotension
d. A low urine specific gravity
E. Nausea and vomiting

NCLEX Question
A client suddenly develops syndrome of inappropriate antidiuretic hormone
(SIADH) after undergoing cranial surgery. Which manifestations should the
nurse expect to see from the client? Select all that apply.

a. Edema and weight gain

b. Decreased urine production
c. Hypotension
d. A low urine specific gravity
E. Nausea and vomiting
Opposites can’t attract
● I can’t…
○ Hold the dose and administer the dose
○ Make the client NPO and offer small frequent meals
○ Increase the rate and decrease the IVF rate
○ Apply heating pads and turn on a fan
○ Etc.
● The client cannot be both
○ Bradycardic and tachycardic
○ Have a prolonged and a shortened PR interval
○ Etc.

Pick ONE… not both!!!

NCLEX Question
A client suddenly develops syndrome of inappropriate antidiuretic hormone
(SIADH) after undergoing cranial surgery. Which manifestations should the
nurse expect to see from the client? Select all that apply.

a. Edema and weight gain

b. Decreased urine production
Opposites!!
c. Hypotension
d. A low urine specific gravity
e. Nausea and vomiting
Answers: B and E
A is incorrect. Because of free water retention, there is increased retention of water in the intravascular space.
But triggers the kidneys to excrete sodium, balancing the fluid status of the client. They are euvolemic. Weight
gain is seen, but peripheral edema is not. This absence of peripheral edema is a specific finding of SIADH.

B is correct. Decreased urine production is a finding of SIADH. Because of the increase in ADH, there is an
increased retention of free water and a decrease in urine output.

C is incorrect. You would expect to see a normal blood pressure in SIADH. Only free water is retained, no sodium,
and the body remains in a euvolemic state. This means that clients with SIADH are normotensive.

D is incorrect. A low urine specific gravity would be seen in DI, when the production of ADH is decreased and the
body secretes large amounts of dilute urine. In SIADH, the body retains free water and makes small amounts of
concentrated urine, so the specific gravity is increased.

E is correct. Nausea and vomiting are expected signs of SIADH

NCLEX Question
The nurse is evaluating their client's lab results and notes that the potassium is 5.5
mEq/L. They review the telemetry monitor, looking for which of the following signs?
Select all that apply.

a. Inverted T waves
b. Widened QRS interval
c. Tall, peaked T waves
d. Prominent U-waves
e. Prolonged PR interval
Answer: B, C, and E
A is incorrect. The normal range for potassium is 3.5 - 5 mEq/L. This client is experiencing hyperkalemia. In
hyperkalemia, there are Tall, peaked T waves. Inverted T waves is a sign of hypokalemia.

B is correct. A widened QRS interval is a very important EKG finding in hyperkalemia. Other EKG changes clients
may experience when they are hyperkalemic include wide, flat P waves, a prolonged PR interval, a depressed ST
segment, and tall, peaked T waves.

C is correct. Tall, peaked T waves is a hallmark sign of hyperkalemia on an EKG. Remember this one - it is a very
common topic for NCLEX questions!! Hyperkalemia leads to serious arrhythmias, and can progress to heart block,
ventricular fibrillation, or even asystole if left untreated.

D is incorrect. The normal range for potassium is 3.5 - 5 mEq/L. This client is experiencing hyperkalemia.
Prominent U-waves are a sign of hypokalemia, or a potassium less than 3.5, not hyperkalemia.

E is correct. A prolonged PR interval is one of the EKG changes that occurs with hyperkalemia.
NCSBN Client Need:
Topic: Physiological Integrity Subtopic: Risk potential reduction

Reference: Cooper, K., & Gosnell, K. (2019). Study Guide for Foundations and Adult Health Nursing-E-Book. Elsevier Health Sciences.

Subject: Fundamentals of care

Lesson: Fluids & Electrolytes

NGN Question
Nurses’ Note
0800 – Client was found in bed pale and diaphoretic, stating, ‘I do not feel well.’ Approximately two minutes later, the
cardiac monitor showed ventricular tachycardia. Upon assessment, the client became unresponsive and did not have a
pulse.

For each potential intervention, click to specify if it is essential or contraindicated.

Intervention Essential Contraindicated

Call a code blue

Cardiovert the client

Defibrillate the client

Anticipate a prescription for intravenous

digoxin

Perform chest compressions

NGN Question - Answer
Nurses’ Note
0800 – Client was found in bed pale and diaphoretic, stating, ‘I do not feel well.’ Approximately two minutes later, the
cardiac monitor showed ventricular tachycardia. Upon assessment, the client became unresponsive and did not have a
pulse.

For each potential intervention, click to specify if it is essential or contraindicated.

Intervention Essential Contraindicated

Call a code blue ✅

Cardiovert the client ✅

Defibrillate the client ✅

Anticipate a prescription for intravenous ✅

digoxin

Perform chest compressions ✅

Second: Use tools to eliminate answer choices

● Eliminate what you know is wrong first.
● If part of the answer choice is wrong, the whole answer is wrong.
● Opposites can’t attract
● Don’t know it? Don’t guess it.
● Least invasive > Most invasive
● Do the work yourself.
● Listen to your client.
 Don’t know it? Don’t guess it.
If you’ve never heard of the

● Med
● Disease
● Symptom
● Assessment finding

Don’t guess it!! Chances are - no one else has either.

You are a NEW nurse, with 2 weeks of general nursing knowledge!

NGN Question
A 22-year-old female was admitted to the emergency department (ED) after wandering in the
local park. The client was disheveled, completely mute during the assessment, and did not
respond to external stimulation. The client had a fixed stare at the ceiling and a marked reduction
in purposeful movements. The physical exam noted flaky skin with tenting and dry mucous
membranes.

Medical records reveal that this client has a history of schizophrenia. Which prescriptions should
the nurse anticipate from the primary healthcare provider (PHCP) based on the history and
physical?

A. Levodopa-Carbidopa
B. Methylprednisolone
C. Lorazepam
D. Intravenous fluids
E. Venlafaxine
F. Levothyroxine
NGN Question
A 22-year-old female was admitted to the emergency department (ED) after wandering in the
local park. The client was disheveled, completely mute during the assessment, and did not
respond to external stimulation. The client had a fixed stare at the ceiling and a marked reduction
in purposeful movements. The physical exam noted flaky skin with tenting and dry mucous
membranes.

Medical records reveal that this client has a history of schizophrenia. Which prescriptions should
the nurse anticipate from the primary healthcare provider (PHCP) based on the history and
physical?

A. Levodopa-Carbidopa← Parkinson?!?!
B. Methylprednisolone
C. Lorazepam
D. Intravenous fluids
E. Venlafaxine
F. Levothyroxine← Thyroid?!?!

NGN Question
A 22-year-old female was admitted to the emergency department (ED) after wandering in the
local park. The client was disheveled, completely mute during the assessment, and did not
respond to external stimulation. The client had a fixed stare at the ceiling and a marked reduction
in purposeful movements. The physical exam noted flaky skin with tenting and dry mucous
membranes.

Medical records reveal that this client has a history of schizophrenia. Which prescriptions should
the nurse anticipate from the primary healthcare provider (PHCP) based on the history and
physical?

A. Levodopa-Carbidopa
B. Methylprednisolone
C. Lorazepam
D. Intravenous fluids
E. Venlafaxine ← Have you heard of this???
F. Levothyroxine
Answer: C and D
Options C, D – Correct – Catatonia is a serious psychiatric syndrome that may occur with
psychiatric and medical conditions. The gold standard treatment for catatonia is
benzodiazepines such as lorazepam. Lorazepam is preferred because of its modulating
effects on the neurotransmitter GABA. The nurse should also request a prescription for
intravenous fluids because the clinical data suggests dehydration (skin tenting and dry
mucous membranes) which is a likely consequence of catatonia.

Options A, B, E, F – Incorrect – Dopaminergic medications (both agonists and antagonists)

should be avoided. Agonists should be avoided because they would trigger psychosis,
therefore, levodopa-carbidopa would be contraindicated. Antagonists may worsen
catatonia and complicate treatment. Therefore, antipsychotics and levodopa-carbidopa are
avoided in the treatment of catatonia. Further, steroids (methylprednisolone), serotonergic
agents (venlafaxine), and thyroid hormone (levothyroxine) have no role in the treatment of
catatonia.

Second: Use tools to eliminate answer choices

● Eliminate what you know is wrong first.
● If part of the answer choice is wrong, the whole answer is wrong.
● Opposites can’t attract
● Don’t know it? Don’t guess it.
● Least invasive > Most invasive
● Do the work yourself.
● Listen to your client.
Least invasive → Most invasive
First: nonpharmacologic interventions

- Music, Aromatherapy, Positioning

Second: less invasive medications

- Acetaminophen, NSAIDs, scheduled meds

Third: invasive medications

- Opioids, PRN antipsychotics

Restraints are always the last resort!!!!

NCLEX Question
The nurse in the psychiatric unit notes that a client with paranoid schizophrenia is
yelling and blocking the television. Other psychiatric clients around him are
getting angry. What is the most appropriate action of the nurse?

a. Restrain the client

b. Escort the other clients from the day room
c. Give Haloperidol IM
d. Approach the client calmly accompanied by two other staff
Answer: D
A is incorrect. Restraining the client should be the last approach for the nurse. The
first intervention should be to talk to the client to remove him from the day room.

B is incorrect. The nurse should not try to remove the other clients from the room. The
nurse should first remove the client from the place.

C is incorrect. An IM injection of Haldol will take 30 minutes to become active. The

nurse needs to remove the client from the day before the situation escalates.

D is correct. The first intervention is to approach the client calmly and attempt to
remove him from the day room. Staff members should not contact the agitated client
alone but should be accompanied by other personnel.

NGN Question
Client Potential Nursing Intervention
Admission Note Need
65-year-old female was admitted for stage IV
ovarian cancer. The client decided to forego Nutritional ☐ Keep the client nothing by mouth (NPO)
further treatment and decided on comfort ☐ Offer high calorie small frequent meals
measures only. The client is drowsy and reports
☐ Use moist swabs to the mouth and lips
nausea and generalized pain. She makes little eye
contact and reports increasing discomfort when Thermo- ☐ Layer the client with warm blankets
the head of the bed is elevated. Skin is cool and
regulation ☐ Apply heating pads to the extremities
mottled. The client is experiencing urinary
incontinence. ☐ Turn on a fan to cool the client
Comfort ☐ Restrain the client during periods of
For each client need, click to specify the potential agitation
nursing intervention that would be appropriate for ☐ Play soothing music and aromatherapy
the client's care. Each category must have at least
☐ Position the client on their side for
one option selected.
gurgling
NGN Question Client
Need
Potential Nursing Intervention

Nutritional ☐ Keep the client nothing by mouth (NPO)

Admission Note
65-year-old female was admitted for stage IV ☐ Offer high calorie small frequent meals
ovarian cancer. The client decided to forego ☐ Use moist swabs to the mouth and lips
further treatment and decided on comfort
measures only. The client is drowsy and reports
nausea and generalized pain. She makes little eye
contact and reports increasing discomfort when
the head of the bed is elevated. Skin is cool and
mottled. The client is experiencing urinary
incontinence.

For each client need, click to specify the potential

nursing intervention that would be appropriate for
the client's care. Each category must have at least
one option selected.

NGN Question Client

Need
Potential Nursing Intervention

Admission Note
65-year-old female was admitted for stage IV
ovarian cancer. The client decided to forego
further treatment and decided on comfort
measures only. The client is drowsy and reports Thermoreg ☐ Layer the client with warm blankets
nausea and generalized pain. She makes little eye ulation
☐ Apply heating pads to the extremities
contact and reports increasing discomfort when
☐ Turn on a fan to cool the client
the head of the bed is elevated. Skin is cool and
mottled. The client is experiencing urinary
incontinence.

For each client need, click to specify the potential

nursing intervention that would be appropriate for
the client's care. Each category must have at least
one option selected.
NGN Question Client
Need
Potential Nursing Intervention

Admission Note
65-year-old female was admitted for stage IV
ovarian cancer. The client decided to forego
further treatment and decided on comfort
measures only. The client is drowsy and reports
nausea and generalized pain. She makes little eye Comfort ☐ Restrain the client during periods of
contact and reports increasing discomfort when agitation
the head of the bed is elevated. Skin is cool and
☐ Play soothing music and aromatherapy
mottled. The client is experiencing urinary
incontinence. ☐ Position the client on their side for
gurgling
For each client need, click to specify the potential
nursing intervention that would be appropriate for
the client's care. Each category must have at least
one option selected.

NGN Question Client

Need
Potential Nursing Intervention

Nutritional ✓Keep the client nothing by mouth (NPO)

Admission Note
65-year-old female was admitted for stage IV ☐ Offer high calorie small frequent meals
ovarian cancer. The client decided to forego ✓ Use moist swabs to the mouth and lips
further treatment and decided on comfort
measures only. The client is drowsy and reports Thermoreg ✓ Layer the client with warm blankets
nausea and generalized pain. She makes little eye ulation
☐ Apply heating pads to the extremities
contact and reports increasing discomfort when
☐ Turn on a fan to cool the client
the head of the bed is elevated. Skin is cool and
mottled. The client is experiencing urinary Comfort ☐ Restrain the client during periods of
incontinence. agitation
✓ Play soothing music and aromatherapy
For each client need, click to specify the potential
✓ Position the client on their side for
nursing intervention that would be appropriate for
gurgling
the client's care. Each category must have at least
one option selected.
 Recap

First: READ the entire Second: Use tools to

question! eliminate answer choices
1. What is this question really asking ● Eliminate what you know is wrong
me?” first.
2. “Am I looking for ‘trues’ or ‘falses’?” ● If part of the answer choice is
3. Phrase the answer choices as true wrong, the whole answer is wrong.
or false questions. ● Opposites can’t attract
● Don’t know it? Don’t guess it.
● Least invasive > Most invasive
Don’t freak out when you get a question on
a topic you don’t know. It’s gonna happen!
● Think back to what you DO know

● Remember the WHYs behind signs and symptoms

● Eliminate what you know is wrong

● And remember….

You WILL be a great nurse!