I studied the Ortho Core Curriculum cover to cover and focused on key points. I had a cd of some practice questions too. I would say it is just a matter of good old fashioned studying, committing to memory as much as possible, while trying to understand what you commit to memory. The test has detailed questions and enough common sense questions to be balanced. It is no piece of cake either. I am Ortho and Med/Surg certified and both tests were equally difficult in their own subject matter. It is the kind of exam that tests your overall knowlege of the specialty intermixed with nursing judgement type questions. It definitely takes studying though, no easy shortcuts, as you must know the information enough to eliminate the obvious wrong answers on the multiple choice questions. Just hit the books! Good luck!