How to Pass Nursing School Exams

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Nursing school is full of different kinds of exams. Let’s dig into some practical tips to help ease the learning curve. We’ve already discussed prerequisites for nursing school, so now let’s talk how to pass nursing school exams.

Common Nursing School Exams

There are different types of testing you will encounter before, during, and after nursing school.

• HESI
• ATI
• TEAS – currently at TEAS 7 version
• NLN PAX
• Your general exams in class
• NCLEX – which will go to NCLEX Next-Gen in 2023

To set up a firm foundation, please know that being someone who absolutely KILLS these exams and is a pro at managing their fears and anxiety every time is a lofty goal. It will take time to get there, and it’s a process – much like learning any new skill.

So, please, give yourself some permission to be a beginner as you learn the best way that works specifically for YOU to conquer nursing school exams.

How to Pass Nursing School Exams

Tip #1 – Understand the Exam

Understanding the exam will inform how you study and manage your time. That way you can maximize every study session because you know it will be moving the needle for you. The way these are set up can vary widely, so you really need to get a basic understanding of what they’ll be testing you on.

If it’s a normal nursing school test or exam, you’ll probably not do the best on the first try. You are still learning the professor and the way questions are asked. Med quizzes will be different than exams over larger sections. Nursing school classroom exams is likely a set exam in which everyone gets the same questions and it’s multiple choice.

Now, when we’re talking about official standardized tests (like HESI, ATI, and the big guy: the NCLEX), the approach should be a bit different. For example, the NCLEX, is a computer adaptive exam. It’s not a simple multiple choice one.

This also means understanding what you’ll be tested on. Is this a comprehensive exam with many topics, or is this an exam of a specific topic (like nephrology, for example). If your professor gives you any hints about the specific topics, take note and devote study time accordingly.

This is much more efficient than just studying the chapter, giving all of it equal weight in your mind and time.

Tip #2 – Take Practice Test(s)

Without studying at all, get a baseline assessment of yourself. No cheating! Seriously, this is going to help guide your studying so genuinely discover what you know and what you need to study. This is very valuable information.

Some nursing school support programs (like Picmonic) will allow you to create customized mini-tests. (Don’t forget to use promo code FRESHRN for 20% off.)

So, if you take a practice test are killed it on the mental health portion but absolutely bombed cardiac, don’t allocate equal time to both of those. Prioritize the cardiac for sure, and dig into it when you are really motivated to study. For those times when you know you need to study but are having a lot of trouble focusing, then do those topics that come a little easier to you.

When I started studying for the CCRN in 2015, I took a practice test and was very surprised at my weak areas. Had I not done the practice test, I would have prioritized my studying differently and likely would have had a lot more trouble with the exam.

Sometimes what we think we’re really knowledgeable about isn’t reflective of reality, so these practice tests can be quite enlightening.

Tip #3 – Always Read the Entire Question

I know, you get excited and see a word or condition you recognize. You even recall a few tidbits of information about it, see an answer listed you cognitively know is connected to it, select it, and confidently move on.

OMG PLEASE DON’T DO THAT.

A common mistake is answering a question that was never asked. Sometimes they pepper in a lot of information at the beginning of the question when it’s ultimately irrelevant. We then disregard the really important information, which is located at the end of the question.

For example, they may give you an entire patient scenario and the listed options are all technically appropriate to do, but the question asks, “What you would do NEXT?”

Usually, the last sentence of the question has the zinger words – things like “highest priority,” “next,” “first,” and “best.”

Seriously, I burned myself so much on this because I got cocky and assumed I was too smart to miss something as easy as this. Before you move on to the next question, you ask yourself:

“Does my selection answer the specific question that was asked?”

– Smart Nursing Student

Tip #4 – Answer Many Practice Questions

Simply getting used to answering questions all the time is a really helpful way to study and solidify information. You can complete short quizzes on your phone while you’re waiting for the bus, in line at Starbucks, and while you’re pretending to lift weights at the gym.

The more you do it, the easier they get. This is a low-risk high-reward methodology because it’s not graded and no one has to know how you’re answering them. There is literally nothing to lose and so much to gain.

Think of how often you open your phone and open TikTok every day. Imagine if you swapped out 3-5 of those instances by doing a handful of review questions instead.

BONUS if you can use something that has immediate feedback with rationales. This can really go much further mentally than reading your textbook. You can do this not only with regular nursing school concepts, but also for NCLEX preparation as well.

I know I keep mentioning them, but Picmonic is an awesome tool that accomplishes this goal. I wish it was around when I was in nursing school back in 2007. It takes away the work of hunting for questions and literally serves them up to you on your phone.

Their app is complete with both content reviews and daily quizzes. You can test your knowledge first, or you can watch a 2-min video on what you need to review, and then take the quiz. They track your progress so you can see where you’re improving, and where you still need work. Click here to check it out. If you decide to buy a plan, use the promo code FRESHRN to get 20% off (you can try it for free first).

Tip #5 – Leverage Spaced Repetition

Have you ever heard of the spacing effect? It is the phenomenon where learning is greater when studying is spread out over time, as opposed to studying the same amount of time in a single session.

I used to cram in long sessions the night before an exam. The next day, my brain would be blank. I just couldn’t access the information in my brain. And then I got really discouraged because it was such a massive waste of time … you study really hard for a long time, only to sit down for the test and not be able to recall that information when you need it.

We tend to think we need to block off a ton of time to really learn something… almost like thinking one REALLY big meal will keep us full for days. But really, we need to have smaller meals more frequently because that’s just how our bodies work. It’s the same with our brains. A big bolus of studying isn’t how your brain will make sense of a brand new concept and be able to apply it later on… it needs repetition, spaced out over time.

So, when talking about nursing school exams, I am a fan of taking part in your lecture and frontloading important information first. Then, sitting back and asking yourself, “What confuses me about this?” and really digging into the things that just don’t make sense. Identify those. Write them down, and take a break.

Next, sit down and leverage whatever resources you have to break through the wall of confusion for 15-20 min with deep focus. Take another break. Rinse and repeat a few times!

Add in micro-learning sessions throughout the week (3-5 min sessions of practice questions), and you’ll find that you genuinely have a deeper understanding of the information and haven’t merely memorized sentences in a textbook.

Tip #6 – Outsmart Your Brain

Do you get distracted after 4 minutes? Does mental health nursing make complete sense to you, but med-surg is like a foreign language?

Everyone is different in what comes naturally to them clinically, as well as how they learn in the classroom. Don’t just look at what the “smartest” student in class does and assume it will work for you (and definitely don’t hate on yourself for not being like them).

This may take a little time to settle into really knowing how you’ll learn best, as nursing school courses are very different from regular college classes. So, give yourself some grace during you first semester as you figure out the expectations of your professors, the difficulty level of the courses, where you need to be really intentional about filling in the gaps, etc.

Remember that your motivation and behavior will fluctuate, so don’t beat yourself up if you’re having a lot of trouble getting started or staying on task. If you know yourself, you’ll know what things you need to do to set yourself up for a successful study session.

(Have a yummy drink, set a timer, close your door, headphones with white noise for example)

This intention could not be more important for people who are more neurodiverse!

Finally, give your prefrontal cortex (PFC) a chance.

When we’re nervous, our amygdala takes over, which uses a lot of brain power. It’s focused more on primal things like safety and your overall emotional experience – and unfortunately easily overidentifies with pain and challenges. However, it’s not responsible for executive-level functioning, which is performed by your PFC.

Simply put, it’s difficult to think clearly when you’re distressed.

Sometimes, we really need to make intentional efforts to calm our sympathetic nervous system down to allow our PFC to kick in.

In-the moment ways to calm yourself down to be able to engage in deep focus:

• Deep and slow belly breaths. In for 4, hold for 4, out for 4. Or just not worry about the counting. Just make sure they’re deep BELLY breaths, which stimulates your vagus nerve, that 10th cranial nerve responsible for the stress response. I recommend practicing this before you really need it because if you have not done these regularly, it is actually somewhat difficult.
• Splash cold water on your face before going to class. Again, this stimulates your vagus nerve.
• Remind yourself that you are safe. This seems silly, but it’s powerful when your brain is trying to take you to all these worst-case scenarios thought cycles (OMG I’M GOING TO FAIL THIS TEST, FAIL NURSING SCHOOL, BE IN TONS OF DEBT WITH NO WAY OF PAYING IT BACK AND MY LIFE IS BASICALLY OVER). This is going to sound weird, but thank you brain for trying to protect you from the worst situation it could possibly come up with, acknowledge it’s not reality (because even if you didn’t do well, it’d be okay and you are still a valuable person with a wonderful life to live – whether or not you pass this test). This gets you out of your own head and takes you from being hijacked by your thoughts to really having ownership over your brain.
• If you are panicking and cannot get your head out of the fog, take a few deep breaths and practice mindfulness for a few moments. Notice the details of the lines on the back of your hands, the smell of the room, how your pen feels in your hand, the taste of your coffee, how it feels to slowly take a deep breath in, and notice what you can hear (birds lightly chirping outside, the hum of the air conditioner, the keys of your professor typing an email.). By focusing on these simple things and forcing your brain to zero in on them, it can’t be anxious simultaneously. It’s the go-to pick. So notice the very small details around you with each of your 5 senses.

More long-term ideas to generally be more of a calm state, rather than activated:

• Regular exercise and things like yoga with calm, intentional breathing can ground you well
• Regular meditation will make it much easier for you to transition out of chaos
• Adequate sleep – no surprises there.
  • Side note: High-quality sleep is literally the most beneficial thing you can do for your health. I view sleep as my #1 priority, above nutrition and exercise.
• Maintain social connections with people with who you feel safe with
• Notice if you are really struggling to chill out and focus; might be time to connect with a licensed professional counselor.

To Summarize

1. Take a little time to understand how the exam is structured and scored
2. Take a practice test
3. Always read the entire question
4. Answer a plethora of practice questions
5. Leverage spaced repetition
6. Outsmart your own brain

What would you add to these tips?

Resources and References for How to Pass Nursing School Exams

• Picmonic – (use code FRESHRN for 20% off)
• The spacing effect
• NCLEX – CAT exam explanation
• How Meditation Calms Your Sympathetic Nervous System
• Sleep Benefits
• Why Deep-Breathing Calms you Down
• How executive functioning is impaired during times of stress