To answer an examination question correctly, knowing the subject content is not enough. You have to clearly understand each part of the question in the context of nursing and correctly interpret the meaning of the question itself. Because nursing is a practice profession and the NCLEXRN is measuring basic practice competencies, questions typically contain a clinical scenario followed by the question stem. In the case of multiple-choice questions, options follow.
When taking an examination, it is important for you to recognize each of these question parts, so read the following definitions and look at the example carefully.
• Clinical scenario: This part of the question tells you about the clinical situation.
• Stem: This part of the question contains the actual problem/ question to be answered.
• Options: These are the answer choices provided. Options are also called alternatives and in the case of traditional multiple-choice questions, consist of one correct answer (the key) and three distracters or incorrect answers. It is important that you read and understand each of these parts correctly for a lot of reasons.
• Facts provided in the scenario are often critical to selecting the best answer to the question. If these facts are not correctly understood, it is difficult to select the best answer.
• If the question being asked is not correctly understood, distracters, which sometimes answer a different question than the one asked in the stem or assume information not provided in the stem or in the scenario, are more likely to be perceived as the correct answer.
• Most questions also contain key words. These are words that direct the answer; hence, attention to them along with clear understanding of their meaning is essential.
KEY WORDS
Because key words are so important in determining the correct answer to a question, a list of frequently used key words is presented below for your review. Note that some of the words are negative.
First
Priority
Next
Best
Most
Least
Appropriate
Inappropriate
Last
Suitable
Not
Early
Late
Immediately
Initial
Only
After
Every
Expected
Contraindicated
Partial
Unexpected
Independently
Common
Uncommon
The following question illustrates the use and importance of a key word:
When giving medications to a client, what should the nurse do first?
1. Position the client
2. Check the client’s identity
3. Explain what he/she is going to do
4. Ask how the client is feeling
In this example, all options are correct nursing actions when giving medications but which one is the correct answer is determined by the qualifying word “first.” The first action is to check the client’s identity.
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