NCLEX Strategies: Don't Predict Answers

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On the NCLEX-RN® exam, you are asked to select the best answer from the four choices that you are given. Many times, the “ideal” answer choice is not there. Don’t sit and moan because the answer that you think should be there isn’t provided. Remember:

  • Identify the Reworded Question.
  • Select the best answer from the choices given.

 

Practice Question


Look at a practice question.

The nurse describes the procedure to a male client for collecting a clean-catch urine specimen for culture and sensitivity testing. Which of the following explanations by the nurse would be most accurate?

  1. “The urinary meatus is cleansed with an iodine solution and then a urinary drainage catheter is inserted to obtain urine.”
  2. “You will be asked to empty your bladder one-half hour before the test; you will then be asked to void into a container.”
  3. “Before voiding, the urinary meatus is cleansed with an iodine solution and urine is voided into a sterile container; the container must not touch the penis.”
  4. “You must void a few drops of urine, then stop; then void the remaining urine into a clean container, which should be immediately covered.”


Step 1. Read the question stem.
Step 2. Focus on the adjectives. “Most accurate” tells you that more than one answer may seem correct.
Step 3. Reword the question stem. What is true about a clean-catch urine specimen for culture and sensitivity?
Step 4. Read each answer choice and ask yourself, “Is this true about a clean-catch urine specimen for culture and sensitivity?”

Answer and Explanation


(1)  This choice describes how to obtain a catheterized urine specimen. Urine isn’t usually collected by catheterization due to the increased risk of infection. This answer does not answer the question about a clean-catch urine specimen. Eliminate.
(2)  This describes a double-voided specimen. This action is usually done when testing urine for glucose and ketones. It is not relevant to a clean-catch urine specimen. Eliminate.
(3)  This is true of a clean-catch urine specimen for culture and sensitivity. The urinary meatus is cleansed, a sterile container is used, and the penis must not touch the container. Leave it in for consideration.
(4)  This does describe a clean-catch urine specimen. The client does void a few drops of urine, stops, and then continues voiding into the container. There is only one problem. For a culture and sensitivity, the container must be sterile. Eliminate.
The correct answer is (3). Many students will select answer choice (4) because they see the expected words: “Void a few drops, then stop; continue voiding.” Be careful. This question is a good example of why scanning for expected words could get you into trouble. You may see expected words in an answer choice that is not correct.

Okay. You’ve practiced how to identify the topic of the question and how to eliminate answer choices. You know that predicting answers does not work on the NCLEX-RN® exam. You are well on your way to correctly answering NCLEX-RN® exam test questions. Unfortunately, this is just the starting point. Let’s talk about specific paths and how you can correctly decide which paths to use on the NCLEX-RN® exam. Remember, the correct answer is at the end of the path!
 
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