N5 Karen Ippolito's Test Taking Helps

This was posted for the Spring 2005 class, and so could be subject to change. It should give us some idea of what to expect.

N5 – Test-Taking Skills Review Nursing 5,
Exam #1 will consist of 50 questions worth 2 points each = 100 total possible points.
The material covered in Units I and II is over 19 chapters, therefore there will be an average of 2-3 questions from each chapter.

Here are some sample questions that will familiarize you with the way that Nursing 5 test questions will look. Answer the sample questions, then scroll down to check your answers and to receive some test-taking tips:

1. A mental health system concern that was shared during both the Period of Enlightenment and the Community Mental Health Period is:
A. Moving patients out of asylums.
B. Studying brain structure and function.
C. Meeting basic human needs humanely.
D. Providing medication to control symptoms.

2. The development responsible for the greatest change in care of the mentally ill in the last half-century is:
A. Self-help groups.
B. Outpatient therapy.
C. Psychotropic drugs.
D. Patients’ rights awareness.

3. Which of the following scenarios can be assessed as demonstrating that the nurse is functioning outside the scope of psychotherapeutic management? The nurse:
A. Assesses a patient for medication side effects.
B. Administers electroconvulsive therapy.
C. Structures meaningful unit activities.
D. Encourages a patient to express feelings.

4. When a nurse administers a drug with anticholinergic properties, it is important to assess for symptoms associated with inhibition of:
A. Spinal nerve function.
B. The central nervous system.
C. The sympathetic nervous system.
D. The parasympathetic nervous system.

5. A 19-year old is admitted to the psychiatric unit following a suicide attempt. The patient receives Prozac 40 mg. qd, attends a variety of group therapies and activities during the day, and in the evening watches TV or talks to visitors. The psychotherapeutic management activity that is lacking is:
A. Adequate drug therapy.
B. Therapeutic milieu therapy.
C. Maintaining contact with significant others.
D. Significant communication with nursing staff

6. A patient who has lung cancer continues to smoke, saying, “I think my cancer is more the result of a bad gene than of smoking.” The nurse can make the assessment that the patient is using:
A. Denial.
B. Compensation.
C. Intellectualization.
D. Reaction formation.

7. A patient begins shouting at the nurse, “Stay away from me.” He is waving his arms in the air and backing into the corner of the room. The initial nursing intervention in this situation should be to:
A. Obtain an order for seclusion.
B. Administer a prn injection of haloperidol.
C. Call for assistance to physically restrain the patient.
D. Talk to the patient in a calm, nonthreatening manner.

8. The nurse who is asked to interpret the goal of psychiatric treatment within a managed care framework to a patient would state, “The goal is to:
A. Promote individual and group health.”
B. Decrease disability and prevent relapse.”
C. Identify individuals with predisposition for mental disorders.”
D. Help the individual achieve an optimal level of functioning in the least amount of time.”

9. When explaining risk assessment, the nurse would indicate that the highest priority for admission to hospital-based care is:
A. Safety of self and others.
B. Confusion and disorientation.
C. Withdrawal from harmful substances.
D. Medical illness complicating psychiatric disorder.

10 The nurse has assessed a patient as having moderately advanced Alzheimer’s
disease. The patient is too confused to be left alone and the family works during the day. A community-based referral the nurse could make would be:
A. Subacute care.
B. A group home.
C. Adult day care.
D. A clubhouse program..

11. During a one-to-one interaction with the nurse, a patient frequently looks nervously at the door. The nurse’s best response to this nonverbal cue would be:
A. “This is our time together. No one is going to interrupt us.”
B. “It looks as if you are eager to end our discussion for today.”
C. “I notice you keep looking toward the door. Is something wrong?”
D. “If you are uncomfortable in this room, we can move to someplace else.”

12. Nursing interventions for a patient exhibiting stage 3 or stage 4 anxiety will be based upon:
A. Meeting dependency needs.
B. Availability of family support.
C. The relief behaviors the patient uses.
D. The issues underlying the anxiety.

13 A patient is shouting loudly and is verbally aggressive. What judgment can the nurse make about this behavior? The behavior:
A Is acceptable if directed toward the nurse, but not another patient.
B Is not harmful and may prevent the patient from physically acting out.
C Is a major warning sign that the patient may become physically aggressive.
D Allows the patient to vent frustration and alleviate stress without hurting anyone.

14. The best outcome the nurse can expect when a psychiatric patient is placed on a psychotropic medication is that the patient will:
A. Be free of side effects.
B. Develop dependence on the drug.
C. Recover and never need the drug again.
D. Improve enough to warrant drug continuation.

15. The environmental element of milieu management with the highest priority is:
A. Clearly establishing norms and designating limits.
B. Scheduling purposeful activities throughout the day.
C. Creating an environment of psychological and physical safety.
D. Promoting a balance between patient dependence and independence.

Answers to Unit I & II sample exam questions:
1. C
2. C
3. B
4. D
5. D
6. A
7. D
8. D
9. A
10. C
11. C
12. D
13. C
14. C
15. C
Remember that the rules of test taking are:

1. Read the question at least 2 times before marking an answer. Check for words such as “but”, “except,” and “not” as these words will change the meaning of the question and guide you to the answer you are looking for.

2. Know that the qualifiers or descriptors that are in the stem of the exam question are there to lead you to the right answer. As a matter of fact, some are like blinking neon arrows that point to the right answer choice. Look at question #10. You are told that the client has “moderate” Alzheimer’s and the family works during the day. the “Moderate” word eliminates the subacute option, and the “works during the day” is the flashing neon arrow that points to the right answer – Adult Day Care.

3. Play the Sesame Street game and sing to yourself the song from that program, “Which one of these things is not like the others...” Look at your possible 4 answers and if there is one that is different and 3 that are similar in concept – then choose the different one. Look at question #6. The first three choices all restrain a patient in some way (medications are “chemical restraint”) and the fourth choice D offers us a choice to use communication. While the patient is acting irrational, he is not posing a threat so we will choose the “different” answer. Also, we know that one of our objectives is to choose the least restrictive intervention while still maintaining safety.

4. Ask your self the following questions:
a. Is there an answer that provides safety for the patient or staff? (question #9)
b. If you have four correct answers, is there one answer that covers the entire situation posed by the question? (look at question #1 and question #8 for an example of this)
c. Only deal with the information that is provided in the exam question – don’t “tell yourself a story” or in other words fill in information that is not provided by the question. See question #5 for an example of this. A student might assume that the patient has nurse contact because the question says he attends group activities – but the question does not state this. Don’t assume. The answer is D.

5. Most of the time, to do really well on an exam, you need to know your material.
Sometimes there are ways to “figure out” the right answer even if you haven’t studied, but many exam questions demand that you have a certain knowledge base about the subject. For example, questions #2, #3 (know the nurses’ scope of practice, #4 (know your drugs), #6 (know your defense mechanisms) require that you have certain factual knowledge before you can answer – so spend the time studying concepts – not just memorizing facts. Memorization may have gotten you through anatomy – but it will not serve you well in nursing where critical thinking and making the right connections lead to the right answers.

6. As you study, define every word that you don’t know. Study with a Webster’s (regular) dictionary and a Taber’s or medical dictionary at your side so that when you come upon a word that you cannot define, you can look it up. Write the definition in your text close to the new word. This is an essential practice because when you come to the test, you will not have the opportunity to look up words that are new to you. So, just look up all new words and you will have a more successful testing experience.