Why you don't need to fear "SATA"

by GrnTea

Students are sometimes thrown by the "select all that apply" format in licensure examinations. Let's talk about why NCLEX uses SATA items, compare and contrast them to "pick the best answer" items, and consider a way you can think about them to prepare successfully.

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    Why you don't need to fear "SATA"

    I will be taking my NCLEX exam this summer. I'm super scared of the SATA amounts that I have seen across the forums.
    Perhaps it would be a good idea to discuss this kind of question, what it means, and why the NCLEX thinks it's a good idea to test new grads using it. Step away from the piles of review questions, stickie notes, and scribbled scraps of paper for a minute, go get a nice cuppa tea, and take a deep breath. This is thinking time, not grab-the-highlighter time. Read on.

    "Select all that apply" means that of the four choices given, more than one may be correct. This is in contrast to the "pick the best answer" that also bedevils new grads. However, the philosophy behind them is the same, and it goes to the heart of your chosen profession. Deep breath again.

    In the "pick the best answer," there are usually two choices that just about anyone can discard out of hand. Of the other two, one is either loaded with at least one buzz-word to make it plausible to a guesser or someone who isn't clear on the concept, OR is also factually correct but not fully applicable to the full meaning of the question.

    The classic example I use to explain this concept is the scenario of the abused wife who, back again after a beating, states she will not leave her husband, and you, the nurse, are counseling her. Of the two plausible correct answers, one is, "And yet you are here. Let's work on a plan to keep you safe." The other is, "You must leave him for your safety. Studies show that he will do it again."

    While both are true, only the first is the correct answer. Why? Because the registered nurse knows that part of her responsibility is to lead the path down to better health, and it is always the patient's decision how to choose to do that. The first acknowledges the situation as it is without judgment, and offers a way for the patient to empower herself in a way that does not deny her choice. The second answer denies the patient's feelings and her expressed desire, and will turn her away from the nurse. The nurse who has a deeper understanding of her professional role will discern the difference. This isn't something you can memorize; it's part of your assuming, internalizing, the professional role.

    SATA questions take this concept to the next step. They tend to look at more complex situations that require more knowledge and judgment than single-answer ones. This is because in nursing there are many, many situations in which more than one thing is going on (such as pain + fear + a pathophysiological issue). There may be interlocking aspects (such as looking at digoxin level + potassium level + diuretic use + assessing patient self-care management) that need to be seen as a whole rather than individual data points.

    SATA situations test your ability to look at the forest, not just the trees. This is a critical skill for a new nurse, so it's clear why a form of question in the examination for initial licensure would include a lot of them.

    Sometimes if you know the why of something, it helps you look at it in a way that leads you to better understanding. In the case of NCLEX, there are questions that test your memorization and understanding of single data points or concepts, and knowledge of how to do what students often call "skills" but are really manipulative (psychomotor) tasks.

    But in SATA questions there are also items that look beyond these, focusing on your performance in the RN role you wish to assume. These are not to be feared but to be approached thoughtfully. You prepare for them not by looking at vocabulary, lists, and lab norms, but by reflecting on the meaning of nursing and the nursing process itself. This is where you take an evening to reread "Notes on Nursing, What It Is And What It Is Not," and pull out your nursing history and theory papers again. Yes, there was a good reason why you studied that. Here it is.

    It takes knowledge and art to practice nursing. Looking at the rationale for SATA questions and reflecting in this way make you appreciate that in nursing, it's almost all "select all that apply." We're glad you're here.

    I wish you well!
    Last edit by Joe V on Jan 31
    rachhpal, Leiloo, LaneeF, and 29 others like this.
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  4. About GrnTea

    GrnTea has been a nurse for a long time in critical care, case management, teaching, and legal nursing. She spends an inordinate amount of time working with students to help them appreciate the richness of our profession and participate in their education more fully, because the students of today will take care of her in the future and they'd better be good.

    GrnTea joined Apr '11 - from 'out in the country'. GrnTea has 'since Florence was a probie' year(s) of experience and specializes in 'legal, teaching, LCP, CM'. Posts: 8,905 Likes: 17,938; Learn more about GrnTea by visiting their allnursesPage


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    38 Comments so far...

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    Thank you so much GrnTea for the through explanation of SATA questions and why it is of importance. I am one of the ones that dislike SATA questions. Now, I see it in a different light. Hence, I will look at it more closely and embrace it so that I can pass my NCLEX. Thank you so much. GrnTea, YOU ARE MY INSPIRATION!
    Workinghard123, melkay60, and GrnTea like this.
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    "like" x 10 times. lol

    I really enjoyed reading this GrnTea.
    melkay60 and GrnTea like this.
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    Very well said. I agree with you. Those are really tricky questions but you nailed it right. This articles is really good help. Thanks for sharing.
    melkay60 and GrnTea like this.
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    When I took my boards, I looked at each answer to choose as a true/false question. The question is asking (_____) if I do A, is that a true statement? Is answer choice B true, also, or false? Same with C, D, and maybe E.
    Leiloo, GrnTea, nae312213, and 3 others like this.
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    Recently sat and passed my NCLEX. Listening to and reading comments of those who already took this exam can be very frightening. The fact that you have completed this your nursing course and has made it thus far means that you have everything you need in you to move to the next point. Trust you instinct and go with your gut the first time. Try to make the connection with the questions and the answer. Ask yourself, if the patient is suffering from a certain condition what is the most logical and immediate action that would be best? Stop over analyzing and just go with your gut! This is coming from one who barely passed class exams due to over analyzing and changing my right answers. Thank God NCLEX does not afford anyone the chance to change answers or I would be going back. The exam stopped at 85 and I was not sure what happened but results proved I was making the right choices. Again, trust your gut!
    Leiloo, Nikkinism70s, sukhvir01, and 1 other like this.
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    Thank you for the reassuring words.
    GrnTea and melkay60 like this.
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    GRN this is an amazing write up.
    Last edit by RNGriffin on Jan 31
    GrnTea and melkay60 like this.
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    Thank you so much for the enlightening explanation. As a non-traditional nursing student it really helped open my eyes to viewing the exams a whole new way. I intend to share with my fellow students. Critical thinking once again!
    GrnTea likes this.
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    Thank you so much for the enlightening explanation. As a non-traditional nursing student it really helped open my eyes to viewing the exams a whole new way. I intend to share with my fellow students. Critical thinking once again!

    That's one of the beautiful things about education. If you knew it all already, you wouldn't be in school. You go to college to learn things you didn't know, to widen your horizons, to stretch your experiences, to consider new and different ways of thinking about things you thought you already understood. This is one of those, and thank you so much for recognizing it!

    Jtinwv, Workinghard123, and sukhvir01 like this.


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