Exam Do’s and Don’ts

Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC, FNAP

Q: My upcoming certification exam will consist primarily of multiple-choice questions. What tips or strategies can you recommend for optimizing my performance on the exam and avoiding the pitfalls of standardized tests?

A: No matter what certification exam you take, all share one thing in common: multiple-choice questions. Some certification exams, such as ANCC, also include multiple response, drag and drop, and hot spot questions, however, the greatest number of questions on certification exams are multiple choice.

Multiple choice is the most popular question format for standardized tests as it allows testing on a large amount of information in a relatively short period of time. While many dread this type of question, there are advantages to the format such as ease of grading and the ability to test the knowledge base of a person with less developed writing skills or problems with expressive language. Specifically, the certification exams are an assessment of the knowledge base of the entry-level NP, an important point to remember as you study. Bearing this in mind, here are some “do’s and don’ts” for the NP certification exams.

Certification Exam Do’s

• Do read each question and response choice so that you mark your answer only after you are sure you understand the concept being tested in the question. Answering a question quickly could lead you to choose a response that contains correct information about a given condition but is not the correct or best response for that particular question.
• Do be wary of options that include extreme words, such as always, never, all, best, worst, or none. Seldom is anything absolute in healthcare.
• Do recall and jot down or highlight a few facts about the information if you are really stumped. Doing this might be enough to facilitate retrieval of information you need to respond to the question. Your testing site will provide writing materials such as a small white board that you can use during the examination. Alternatively, most testing software allows for highlighting keys words within the question.
• Do remember that if the answers cover a wide range of numerical values, a value at or near the middle is often correct.
• Do make sure that the extra information usually found in a particularly long answer is pertinent to the question and not simply there to distract you.
• Do read the shortest answer with care before you reject it. While the short option gives little detail, there might be enough information in it to make it correct.
• Do notice if two answer choices look similar. In most cases, one of these items is the correct answer.
• Do note when two answers convey the same information or have the same meaning. Usually both are wrong.
• Do read each query as if it were a true-false question, eliminating all the answers that are false.
• Do expect that the topics you studied will be presented in random order. For example, on the adult-gerontology primary care NP examinations, a question on diabetes mellitus can follow one on hypertension and can be followed by a question on women’s health. In the family NP exam, a question on an elderly patient can be followed by a question about a newborn.
• Do recall that the certification exams are geared to test if you possess and can apply the knowledge base to practice as a safe, entry-level NP. As a result, you need to apply knowledge you have learned in a new or novel way to correctly answer a question.
• Do allow evidence-based practice to guide your choice of an answer. Expect that advice on health screenings and interventions is based on nationally recognized standards of care from authorities such as the American Diabetes Association, American Heart Association, and the US Preventative Services Task Force, not simply what you have observed being done in clinical practice.

Certification Exam Don’ts

• Don’t forget that the computer-based test sites accommodate the needs of a number of different test candidates. For details, review the special accommodations section of the certification handbook for the exam you have chosen. Although the sites are generally quiet locations, people will be moving in and out of the test area. Use earphones or earplugs that are provided by the testing center if you are easily distracted.
• Don’t be misled by the close-to-correct choice that often precedes the correct answer.
• Don’t assume that an answer is correct because this is what you have observed in your current nursing practice or in your clinical rotations. Again, let evidence-based practice guide your choice of response.
• Don’t dismiss an option because it seems too obvious and simple to be correct. If you are well prepared for the exam, some of the questions will appear quite straightforward.
• Don’t select an option just because it contains factually correct information about the clinical situation. With multiple-choice questions, often more than one answer is technically correct, but one is the best answer.
• Don’t pick an answer just because it seems to make sense. You are answering from your knowledge of the exam content, not from your general knowledge and logic alone.
• Don’t be taken in by the use of unfamiliar terms in the question. If you have studied the subject, few words should be unknown.
• Don’t get bogged down on one question if you are unsure or stumped about an answer. A better strategy is to move on and finish all the questions you can answer and come back later to process the problematic questions. The computer-based tests have a mechanism to highlight questions you want to revisit.
• Don’t change an answer unless you misinterpreted the question. If necessary, when looking over the questions again, change an answer only if you can logically justify the change.
• Don’t respond to self-defeating thoughts that can creep into your mind, such as, “I did not study enough,” or “This test is too hard.” Recognize the time and energy you have invested in preparing for the exam.

In conclusion, do what you can to maximize your success; prepare for the exam by taking the Fitzgerald Certification Exam Review. Don’t forget that your certification preparation will also serve you well in your new practice.