This exam is like nothing one ever experiences in nursing school
. And the expectations (and the passing score) are very high. There are questions on literally any scenario one might encounter, and often a series of questions linked to each other. No one can know everything, and if you're weak in an area, for example complications of labour, and there are twenty questions on shoulder dystocia, you could blow a huge part of the exam. As well, the answers are never straight-forward, they are typically multiple-multiples...
1. a only
2. a and b
3. a,c and f
4. a,b,c and f
5. all of the above
And in the last year the format has changed from purely multiple choice to a combination of multiple choice, short- and long- answers. Subjective? Maybe. The psychosocial, therapeutic communications type questions, of which there are always a good number, are very hard. They are never worded the way a real person would speak, and one has to give it their best guess! It's been more than 12 years since I wrote mine, and I still remember the terror.