Test Taking Tips and Strategy for Nursing Students

Alternate item formats are generally the most dreaded questions on exams. Usually instructors will throw in one to two of them into the majority of multiple choice questions on exams. They are usually the questions that students get wrong.

So what are alternate item formats? Alternate item formats are pretty much any question that is not multiple choice. They include multiple response questions, fill-in-the-blank, hot spot questions, and prioritizing questions.

Multiple response questions are generally the questions that state, "select all that apply." A simple strategy to answer these questions is to ask yourself, "what is the question asking?" Then go through each of the possible answers and determine if it is true or false. If it is true, select it. If it is false, don’t. Afterwards simply move on and don’t spend time thinking of "maybes" because there are none.

Fill-in-the-blank questions will usually be calculation problems. The best practice for these is to work out the problem and put the answer in the blank. Then, before submitting it, work the problem all over again to determine whether you get the same answer. If it is, submit it. If it is not, rework it. Usually the answer is just the number. Read the directions carefully to determine if the unit is desired.

Hot spot questions are either an illustration or a figure. This can mean a medication label, heart strip, etc. These questions can be asked in multiple choice, multiple response, fill-in-the-blank, etc. Remember to read the question and focus on the illustration. Then use the specific strategy for the type of question.

The next type of question is the prioritizing question. First visualize the situation and then use your nursing knowledge to answer the question. Remember to use the ABCs (airway, breathing, circulation) to prioritize your steps. Don’t forget to use Maslow’s Hierarchy, the nursing process, and teaching and learning principles to organize your interventions.

Focus on doing well on alternate format items while you can. Usually when taking the NCLEX exam they are the questions that are the hardest. If you can improve your skills now, while in school, it will only improve your chances of succeeding later on the NCLEX.