How to choose the BEST answer?

Students General Students


Hey All,

Well, I passed my foley check-off today. A small victory, but a victory nonetheless right?

Multiple choice questions worded as nclex questions are another story. One of my teachers (who is great, but tough) has told us she's starting us out early, and wants us to know that this is what we can expect. Questions that are worded in such a way, and that are similar to nclex-type questions. Well, everyone in my class did poorly on her quiz, and we began asking, "how would we evaulate this question to determine the best answer?" 3 of the answers were "correct" but which one was the "best"? She didn't offer up lots of suggestions, and as someone that has always had more common sense than "book smarts", I am truly blown away at how close some of the answers were. It seemed almost like a judgement call rather than a scientific way to differentiate that one answer was better than the other.

I'm not sure if that made a whole lot of sense, but I was hoping some experienced nursing students could share their thoughts and advice. BTW, I asked my teacher if buying a nclex-review book this early on would prove helpful and she said probably not?

Any suggestions, practice test websites, encouragement, would be very appreciated...


Spec :specs:


47 Posts

Specializes in Medical/Surgical, PACU, ICU, and Psych.

spec....i think that is one of the hardest parts of nursing school. it is really rough having to get used to questions that are potentially all correct, but only ONE is the best answer.

i guess the only advice i can give is for you to know WHY one answer would be more correct.....just think thru the answers and if you know your stuff for the test, some of them just won't make as much sense.

i know that is really vague, and i'm sorry, but i'm a junior this year and after three years i still get frustrated at those multiple choice questions! :) sorry i couldn't be of more help....but you will be able to do it....just keep going, keep thinking, keep learning, and remember, practice makes perfect. ;)

Long Term Care Columnist / Guide

VivaLasViejas, ASN, RN

108 Articles; 9,984 Posts

Specializes in LTC, assisted living, med-surg, psych.

There's really only one rule about tests, whether you're in school or sitting for the boards: The "best" answer is the *safest*. Visualize the practice situation, then choose what you believe would be the safest action to take based on the information given.

This is how they determine whether you're a safe BEGINNING practitioner---notice that I said "beginning", they don't expect you to come out of nursing school knowing it all.

Good luck to you!

Specializes in PCU, Critical Care, Observation.

I can't believe that she doesn't explain why the correct answer is the best choice out of the four. My instructor reviews the exam as soon as we are done taking the test. She goes over each & every question. If someone is confused as to why one answer is better than another, she'll explain it.....they are not always happy with her explanation Plus, sometimes two of the answers truly are the best answer depending on the question. If we can come up with a good reason as to why, she will give us credit for it.

I would try to get your instructor to be a little more informative. There are test taking books for nursing students....they will explain what to look for......because a lot of times I've noticed---you really have to pay attention to what they are asking for. It's the little key words in the question that can throw you off if you aren't paying attention. I recently purchased a couple of nclex books, so I don't know if they are helpful or not. Check them out at the library or look at them at the bookstore & see if they offer explanations as to why the answers are correct or incorrect.

The test taking book I have is called "Test Success: Test-taking Techniques for Beginning Nurses Students" by Patricia Nugent & Barbara Vitale. It has detailed explanations as to why one answer is better than the other.


385 Posts

i cut and pasted my reply from another board that spec and i both read, my replies in red.

i've also had 2 quizzes in my health assessment class and our teacher has told us she's throwing us right into the fire and giving us questions that are going to like what we can expect all thru nursing classes and for the nclex exam.

from the get-go all our tests were nclex style

although i'm very glad she's preparing us, i feel like the questions are very difficult as first semester clinical students. for instance, in one of the questions she gave us (i wish i could remember what it said) there were 3 right answers, but she said we had to determine the best answer. many kids in our class argued that it was a judgement call and they were all so close, how were we to determine how to choose the right answer?

we had a question in neuro something like, the client walks into the er after sustaining a fall, what's the first thing you assess? answers included pupils, respiratory status and a couple other choices i forget. i can't remember what answer i put but respiratory status was the correct answer (it almost always is, if it's one of the choices) but since it said she walked in, i figured she was breathing. well, the instructor said, well then you did assess the resp status. lol

our teacher basically said, we'll learn, but we're really worried. passing at my school is a 76%. that means an 80 is a d. i asked if maybe a nclex review book might prepare us for our tests and teach us some skills on how to evaluate a question, break it apart, and help determine what is the right answer for that question, but my teacher said at this point that would do us no good. any suggestions?????

my suggestion is saunders comprehensive review for nclex-rn, especially for the first year. it contains most of the info from all your books crammed into one book set up in outline form. the info is broken down into small sections, with review questions after each chapter, unlike some of the other review books that are only broken down by, peds, psych, and med-surg. here is a link with some info about the book.

barnes_& - saunders comprehensive review for nclex/rn


603 Posts

If you are unsure, you are probably best off going with your first impulse.


124 Posts

thanks again Sandra, and everyone!!!!! :)


198 Posts

We have a "how to take nusing tests" tutorial in our computer lab. Before the last test (pre final) last semester I checked it out! I am SO GLAD I did!! Here's the jist of it:

There are 4 Critical elements to every questions and you need to ID them before you can answer.

ISSUE - primary problem the question asks about

CLIENT - person who is focus of the stem of the question (this is not always the patient, so pay attention)

KEY WORDS - most important words like "best" "most likely", etc

STEM - asks to solve the problem presented

** The stem can either ask for a TRUE statement or a FALSE statement (ex: which would you NOT do is a "false" stem)

So after ID your parts you can eliminate any answers that don't agree with the STEM...if it's a TRUE stem you can eliminate any answers that are "false" if you can write on your test you might want to put "+" and "-" next to each choice. That usually eliminates at least one choice.

Once you've done that you can restate the question in your own words if that helps you.

Eliminate any choices which contain NEW INFO!! If the choice contains additional info about the situation that is NOT in the original question, eliminate it.

IF that hasn't "ID'd" your answer there are 3 strategies that might help (these are my favorite and the SAVED MY BUTT):

#1 Look for "global response" answers. General/comprehensive statement which may include correct ideas from other choices. These are usually choices in questions that ask for "general", "overall" or "best nursing approach" questions.

for example if one choice mentions taking vitals and another specifies Temp and BP then the vitals one would be right because it includes T & BP

#2 Eliminate similar "distractors" - if 3 out of 4 choices mention skin integrity - they are probably not the right answer - sometimes they are written to be sneaky - they might mention "skin moisture" in one and "apply lotion" in another but both are about skin integrity.

#3 Look for similar words in choices from the question. If the question mentions a specific disease process the choice that also mentions the disease process may be the correct answer.

ALSO!!!!! Don't forget to look at choices in respect to Maslow's Hierarchy!!!!!


Then: nutrition, elimination, maintenance of physical integrity and equilibrium, sleep.

Patient teaching/learning questions - the correct answer is often realted to the patient's motivation.

PHEW I hope that helps!! I seriously got about 4 more questions correct on the test I took right after this tutorial because I used the strategies!!


Shelly =)

Hellllllo Nurse, BSN, RN

3 Articles; 3,563 Posts

It helped me to pay attention to specific words in the questions- words like : first, most, best. least, always, etc can drastically change the meaning of a question.

Sometimes, I felt that the "most correct" answer was really not the most correct answer, as in the question you got about the woman walking into the ER w/ a head injury.

It does seem like the best answer to check pupils first.

But, the fact that she was breathing was seen right away, which really was a mini assessment. Know what I mean? =0)


198 Posts

Originally posted by Hellllllo Nurse

It does seem like the best answer to check pupils first.

But, the fact that she was breathing was seen right away, which really was a mini assessment. Know what I mean? =0)

You have to use the hierarchy!!! ABCs FIRST!! This bit me in the arse on the first couple tests...I was thinking like you..head injury...ummm...check pupils!! but they want you to use the hierarchy in everything.

Specializes in PCU, Critical Care, Observation.

hmmm....and we were just taught that respiratory is one of the first things you check no matter who the patient is. i imagine the key word was head injury. although i can hear my instructor's voice saying "it doesn't matter what her pupils look like if she stops breathing."

we had a question about a woman in the hospital recovering from a stroke. she was weak on one side of her body & had been laying in the same position all night. she is alert & oriented...what's the first thing you do.......bed bath, range of motion exercises, check respiratory or change her position in bed because she is too weak to do it herself. the answer was to check respiratory.

nurseshell----those are great test taking tips---i need to go over them myself. looking back on my last exam, the wording is whee people trip themselves up. for instance, one question are giving an injection, what is the best safety measure for the nurse? the options wash hands, to put on gloves, to wash hands & put on gloves or to give the shot without any gloves. some of us put to wash hands (because they drill into us......always wash your hands), others put wash hands & put on gloves............but the key words were "the best safety measure for the nurse"......not for the patient & of course gloves are the best for the nurse in that situation.

here is the page that my school has for test tips...


124 Posts

Thanks NurseShell, those are great tips. I will incorporate everyones great ideas and really appreciate you all taking the time to share you advice!!!!



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