{"id":15004,"date":"2019-09-06T14:08:44","date_gmt":"2019-09-06T19:08:44","guid":{"rendered":"http:\/\/www.kaptest.com\/blog\/prep\/?p=15004"},"modified":"2020-09-11T20:40:50","modified_gmt":"2020-09-11T20:40:50","slug":"strategies-for-mastering-exam-questions","status":"publish","type":"post","link":"https:\/\/wpapp.kaptest.com\/study\/pance\/strategies-for-mastering-exam-questions\/","title":{"rendered":"Strategies for Mastering Exam Questions"},"content":{"rendered":"<p class=\"p1\">What are the steps you should aim to incorporate into your approach to dealing with PANCE questions? They need to be generic enough to work with different kinds of questions. These steps also need to protect you from making <a title=\"Common PANCE Errors\" href=\"http:\/\/www.kaptest.com\/blog\/prep\/pance\/common-pance-errors\/\">mistakes<\/a> that could hurt you. Let\u2019s look at the approach to questions used by many good test takers and focus on why it works.<\/p>\n<div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h4  blockquote modern-quote  avia-builder-el-0  el_before_av_hr  avia-builder-el-first  '><h4 class='av-special-heading-tag '  itemprop=\"headline\"  >The Basic Steps<\/h4><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<p class=\"p2\"><span class=\"s1\">1.\u00a0<\/span>Read the question carefully to locate the important clues.<\/p>\n<p class=\"p2\"><span class=\"s1\">2.\u00a0<\/span>Make sure you fully understand what\u2019s being asked.<\/p>\n<p class=\"p2\"><span class=\"s1\">3.\u00a0<\/span>Before looking at any answer choices, put the clues together with what you are being asked and allow your mind to form an answer.<\/p>\n<p class=\"p2\"><span class=\"s1\">4.\u00a0<\/span>Look at the choices offered, and if one of them fits your anticipated answer, mark it.<\/p>\n<p class=\"p2\"><span class=\"s1\">5.\u00a0<\/span>If no choice is a good fit, use general knowledge, larger concepts, and logic to eliminate as many choices as you can.<\/p>\n<p class=\"p2\"><span class=\"s1\">6.\u00a0<\/span>Select an answer from the remaining choices.<\/p>\n<p class=\"p2\"><span class=\"s1\">Not all of these steps will necessarily be used with every question. For example, if a question\u00a0<\/span>asked which bacterial organism is most commonly responsible for neonatal pneumonia and you remembered it, then the process would stop at Step 4. However, in most standardized examinations, many questions will ask you to assess specifics that you won\u2019t be able to recall. It is in dealing with these questions that good test takers have a real advantage over those who are less adept. So, just what methods are used to get more correct answers?<\/p>\n<p class=\"p4\"><div  style='height:20px' class='hr hr-invisible   avia-builder-el-1  el_after_av_heading  el_before_av_icon_box '><span class='hr-inner ' ><span class='hr-inner-style'><\/span><\/span><\/div><\/p>\n<p class=\"p4\"><article  class=\"iconbox iconbox_left    avia-builder-el-2  el_after_av_hr  el_before_av_heading  \"  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/BlogPosting\" itemprop=\"blogPost\" ><div class=\"iconbox_content\"><header class=\"entry-content-header\"><div class=\"iconbox_icon heading-color\" aria-hidden='true' data-av_icon='\ue817' data-av_iconfont='entypo-fontello'  ><\/div><h3 class='iconbox_content_title  '  itemprop=\"headline\"  >Remember<\/h3><\/header><div class='iconbox_content_container  '  itemprop=\"text\"  ><p>\u00a0<span class=\"s1\">Often there is more than\u00a0<\/span>one right answer, but the question is asking for the best answer. Read all answer choices before jumping to a conclusion.<\/p>\n<p class=\"p4\">\n<\/div><\/div><footer class=\"entry-footer\"><\/footer><\/article><\/p>\n<div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h3    avia-builder-el-3  el_after_av_icon_box  el_before_av_heading  '><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >The Methods<\/h3><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div>\n<p class=\"p2\"><span class=\"s1\">The arsenal of test strategies is hinted at in Step 5 above, which directs the use of gen<\/span>eral knowledge, larger concepts, and logic. Unconfident test takers are prone to an either\/or mindset when they encounter questions. If, after reading the question, they aren\u2019t sure of an answer based on what they recall, they quickly give up and guess. <a title=\"5 Tips for PANCE Test Day\" href=\"http:\/\/www.kaptest.com\/blog\/prep\/pance\/5-tips-for-pance-test-day\/\">Good test takers<\/a> use information presented in the question itself or more of their general knowledge to chip away at the question. By persevering and exploiting whatever they can to eliminate choices, they more frequently end up with correct answers. But frankly, just talking about what\u2019s involved in abstract terms isn\u2019t likely to make you a better test taker. To accomplish that goal, you will have to see test strategies in action.<\/p>\n<p class=\"p2\"><span class=\"s1\">Strategies really can\u2019t be taught out of context. To give you a sense of how to use strategies,\u00a0<\/span>we are going to illustrate them with examples, followed by a discussion of how applying a strategy narrows the possible answers and, in many cases, allows a test taker to obtain correct answers by knowing something about the topic of the question but not enough to mark an answer using only recalled information.<\/p>\n<p><div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h4  blockquote modern-quote  avia-builder-el-4  el_after_av_heading  el_before_av_promobox  '><h4 class='av-special-heading-tag '  itemprop=\"headline\"  >Eliminate distractors by applying basic principles<\/h4><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div><br \/>\n\t<div   class='av_promobox  avia-button-no   avia-builder-el-5  el_after_av_heading  el_before_av_promobox '>\t\t<div class='avia-promocontent'><\/p>\n<p class=\"p4\"><span class=\"s1\">A neonate has a flat, dark-pigmented area of skin over the sacral region. The area\u00a0<\/span>is roughly oval, has a clearly defined border, and differs from surrounding skin only in color. Which of the following is the most likely diagnosis?<\/p>\n<p class=\"p4\"><span class=\"s1\">A.\u00a0<\/span>Diastematomyelia<\/p>\n<p class=\"p4\"><span class=\"s1\">B.\u00a0<\/span>Mongolian spot<\/p>\n<p class=\"p4\"><span class=\"s1\">C.\u00a0<\/span>Nevus flammeus<\/p>\n<p class=\"p4\"><span class=\"s1\">D.\u00a0<\/span>Pilonidal cyst<\/p>\n<p class=\"p4\"><span class=\"s1\">E.\u00a0<\/span>Spina bifida<\/p>\n<p>\n<\/div><\/div><\/p>\n<p class=\"p2\"><span class=\"s1\"><em>Strategy<\/em>:\u00a0<\/span><span class=\"s1\">The use of strategies never guarantees a correct answer; however, they allow you to\u00a0<\/span>extrapolate from what you do recall and relate that knowledge to the specifics of a given question. In this item, if you didn\u2019t know the answer (choice B), you could still eliminate choice E because the patient\u2019s findings would be more severe for spina bifida. You might also reason that it wouldn\u2019t be a cyst (choice D) because the stem of the question states that the area differs only in color, whereas with a cyst, you would expect a palpable mass. Knowing some word etymology might help you eliminate choice C (\u201cflammeus\u201d [flame] suggests either redness or heat, which is not mentioned in the description). This leaves choices A or B to choose from. Now you have a 50%\u2014instead of a 20%\u2014chance of getting the question right.<\/p>\n\t<div   class='av_promobox  avia-button-no   avia-builder-el-6  el_after_av_promobox  el_before_av_heading '>\t\t<div class='avia-promocontent'><\/p>\n<p class=\"p2\"><span class=\"s1\">In the two oxygen-hemoglobin dissociation curves shown below, normal findings\u00a0<\/span><span class=\"s1\">are represented by the solid line and abnormal findings are represented by the\u00a0<\/span><span class=\"s1\">dotted line, indicating a situation in which the curve has been shifted. Shifts such\u00a0<\/span>as this can occur under which of the following circumstances?<\/p>\n<p><div  class='avia-image-container  av-styling-    avia-builder-el-7  avia-builder-el-no-sibling  avia-align-center '  itemprop=\"image\" itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/ImageObject\"  ><div class='avia-image-container-inner'><div class='avia-image-overlay-wrap'><img class='wp-image-0 avia-img-lazy-loading-not-0 avia_image' src=\"http:\/\/www.kaptest.com\/blog\/prep\/wp-content\/uploads\/sites\/21\/2017\/05\/Screen-Shot-2017-05-06-at-1.46.36-PM.png\" alt='' title=''   itemprop=\"thumbnailUrl\"  \/><\/div><\/div><\/div><\/p>\n<p class=\"p4\"><span class=\"s1\">A.\u00a0<\/span>Carbon monoxide poisoning<\/p>\n<p class=\"p4\"><span class=\"s1\">B.\u00a0<\/span>Decreased pH<\/p>\n<p class=\"p4\"><span class=\"s1\">C.\u00a0<\/span>Increased 2,3-diphosphoglycerate (2,3-DPG)<\/p>\n<p class=\"p4\"><span class=\"s1\">D.\u00a0<\/span><span class=\"s1\">Increased pCO<\/span>2<\/p>\n<p class=\"p4\"><span class=\"s1\">E.\u00a0<\/span>Increased temperature<\/p>\n<p>\n<\/div><\/div>\n<p class=\"p2\"><span class=\"s1\"><em>Strategy<\/em>:\u00a0<\/span><span class=\"s1\">If you recall that a left shift causes oxygen to load and a right shift causes oxygen to\u00a0<\/span><span class=\"s1\">unload, then you can figure out the answer to this item without strategies. If you don\u2019t recall,\u00a0<\/span><span class=\"s1\">however, you can analyze the choices, seeking interrelationships. Look at choices B, C, D, and\u00a0<\/span><span class=\"s1\">E, which would all occur when a person exercises. With exercise, more oxygen is needed, so\u00a0<\/span><span class=\"s1\">you would want the body to react with a right shift. By elimination, the factor causing a left\u00a0<\/span><span class=\"s1\">shift must be choice A, carbon monoxide poisoning, because it is the only effect not likely\u00a0<\/span>resulting from the oxygen demands being increased due to vigorous exercise.<\/p>\n<p><div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h4  blockquote modern-quote  avia-builder-el-8  el_after_av_promobox  el_before_av_promobox  '><h4 class='av-special-heading-tag '  itemprop=\"headline\"  >Recognizing a question in disguise: What is really being asked?<\/h4><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div><br \/>\n\t<div   class='av_promobox  avia-button-no   avia-builder-el-9  el_after_av_heading  el_before_av_promobox '>\t\t<div class='avia-promocontent'><\/p>\n<p class=\"p4\"><span class=\"s1\">A 16-year-old girl comes from a very religious family and denies any sexual\u00a0<\/span><span class=\"s1\">activity. She has severe acne unresponsive to previous treatment of conventional\u00a0<\/span><span class=\"s1\">therapy. Which of the following laboratory studies should be performed prior to\u00a0<\/span>prescribing isotretinoin?<\/p>\n<p class=\"p4\"><span class=\"s1\">A.\u00a0<\/span>Lipid profile<\/p>\n<p class=\"p4\"><span class=\"s1\">B.\u00a0<\/span>Liver function studies<\/p>\n<p class=\"p4\"><span class=\"s1\">C.\u00a0<\/span><span class=\"s1\">Measurement of serum urea nitrogen (BU<\/span>N)<\/p>\n<p class=\"p4\"><span class=\"s1\">D.\u00a0<\/span>Complete blood count (CBC)<\/p>\n<p class=\"p4\"><span class=\"s1\">E.\u00a0<\/span><span class=\"s1\">Measurement of urine\u00a0<\/span><span class=\"s1\">\u03b2<\/span>-hCG<\/p>\n<p>\n<\/div><\/div><\/p>\n<p class=\"p2\"><span class=\"s1\"><em>Strategy<\/em>:\u00a0<\/span><span class=\"s1\">First, make sure you understand what is actually being asked. You\u2019re dealing with\u00a0<\/span><span class=\"s1\">someone who is potentially sexually active (any young woman of reproductive age should\u00a0<\/span><span class=\"s1\">be assessed for pregnancy); therefore, it is always necessary to check for pregnancy before\u00a0<\/span><span class=\"s1\">prescribing a drug that could affect a developing embryo. Knowing this, you could correctly\u00a0<\/span><span class=\"s1\">answer this item (choice E) without knowing much, if anything, about the properties of the\u00a0<\/span>specific drug isotretinoin.<\/p>\n\t<div   class='av_promobox  avia-button-no   avia-builder-el-10  el_after_av_promobox  el_before_av_heading '>\t\t<div class='avia-promocontent'><\/p>\n<p class=\"p4\"><span class=\"s1\">A 4-year-old boy is admitted with respiratory difficulty. He has had several\u00a0<\/span><span class=\"s1\">previous admissions for pneumonia. History is significant for the failure to pass\u00a0<\/span><span class=\"s1\">meconium at birth. Temperature is 101.1\u00b0F, and respirations are 35\/min. Physical\u00a0<\/span><span class=\"s1\">examination reveals a thin, malnourished boy &lt;5th percentile for height and\u00a0<\/span><span class=\"s1\">weight. Rales are heard over the left lower lobe, and percussion over the region\u00a0<\/span><span class=\"s1\">is dull. Sputum culture grows\u00a0<\/span><span class=\"s1\">Pseudomonas aeruginosa<\/span><span class=\"s1\">. Which test would\u00a0<\/span>confirm the diagnosis?<\/p>\n<p class=\"p4\"><span class=\"s1\">A.\u00a0<\/span>Bronchoscopy<\/p>\n<p class=\"p4\"><span class=\"s1\">B.\u00a0<\/span>Chloride sweat test<\/p>\n<p class=\"p4\"><span class=\"s1\">C.\u00a0<\/span>CT scan of the thorax<\/p>\n<p class=\"p4\"><span class=\"s1\">D.\u00a0<\/span><span class=\"s1\">D-x<\/span>ylose absorption test<\/p>\n<p class=\"p4\"><span class=\"s1\">E.\u00a0<\/span>Pulmonary function tests<\/p>\n<p>\n<\/div><\/div>\n<p class=\"p2\"><span class=\"s1\"><em>Strategy<\/em>:\u00a0<\/span><span class=\"s1\">This item illustrates the policy of portraying diseases in their most classic presenta<\/span>tions on entry-level licensure examinations. The boy\u2019s history and symptoms are textbook indications of cystic fibrosis, so the correct answer is B. Notice that examinees don\u2019t receive credit for knowing what disease the boy has, only for reaching a correct diagnosis and then using that knowledge to answer the question posed (i.e., which test would confirm that diagnosis).<\/p>\n<p class=\"p2\"><div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h4  blockquote modern-quote  avia-builder-el-11  el_after_av_promobox  el_before_av_promobox  '><h4 class='av-special-heading-tag '  itemprop=\"headline\"  >Recognizing a question in disguise: Red Herrings<\/h4><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div><\/p>\n\t<div   class='av_promobox  avia-button-no   avia-builder-el-12  el_after_av_heading  el_before_av_promobox '>\t\t<div class='avia-promocontent'><\/p>\n<p class=\"p4\"><span class=\"s1\">A 52-year-old physician whom you know socially has taken secobarbital, 2 g daily,\u00a0<\/span>for 7 years, despite several attempts to stop using the drug. He has been abstinent from alcohol for 10 years. The patient weighs 72 kg (158 lb). Examination shows no abnormalities. Which of the following is the most appropriate next course of action?<\/p>\n<p class=\"p4\"><span class=\"s1\">A.\u00a0<\/span>Detoxification as an outpatient and referral for group treatment<\/p>\n<p class=\"p4\"><span class=\"s1\">B.\u00a0<\/span>Discontinuation of secobarbital and prescription for a benzodiazepine in equivalent doses<\/p>\n<p class=\"p4\"><span class=\"s1\">C.\u00a0<\/span>Hospitalization for detoxification<\/p>\n<p class=\"p4\"><span class=\"s1\">D.\u00a0<\/span>Psychotherapy<\/p>\n<p class=\"p4\"><span class=\"s1\">E.\u00a0<\/span>Suggest that he gradually reduce the dosage of secobarbital<\/p>\n<p>\n<\/div><\/div>\n<p class=\"p2\"><span class=\"s1\"><em>Strategy<\/em>:\u00a0<\/span><span class=\"s1\">Watch out for the item-writing tactic displayed in this question. The stem clearly\u00a0<\/span>states that this man has a history of addictive behavior (alcohol, drugs). But by making the patient a physician, the test writer is trying to confuse the strength of your convictions. Are you willing to hospitalize him, even though this might be a difficult step for you to take? Because the patient has responsibility for the well-being of others, it is even more important to take the tough but appropriate action so that his addiction won\u2019t negatively affect patients\u2019 welfare. Therefore, he should be hospitalized for detoxification (choice C).<\/p>\n\t<div   class='av_promobox  avia-button-no   avia-builder-el-13  el_after_av_promobox  el_before_av_heading '>\t\t<div class='avia-promocontent'><\/p>\n<p class=\"p4\"><span class=\"s1\">A patient in chronic renal failure has five relatives as potential donors. A one-\u00a0<\/span>way mixed lymphocyte reaction is performed, isolating lymphocytes from each relative and treating the cells with mitomycin-C to prevent DNA replication. The cells are incubated with the patient\u2019s untreated lymphocytes in the presence of titrated thymidine for 2 days. The DNA is isolated, and the radioactive counts (CPM) are measured. Based on the assays, who is the best potential donor?<\/p>\n<p class=\"p4\"><span class=\"s1\">A.\u00a0<\/span>Father (lymphocytes 24,000 CPM)<\/p>\n<p class=\"p4\"><span class=\"s1\">B.\u00a0<\/span>Mother (lymphocytes 18,000 CPM)<\/p>\n<p class=\"p4\"><span class=\"s1\">C.\u00a0<\/span>Grandfather (lymphocytes 30,000 CPM)<\/p>\n<p class=\"p4\"><span class=\"s1\">D.\u00a0<\/span>Brother (lymphocytes 1,500 CPM)<\/p>\n<p class=\"p4\"><span class=\"s1\">E.\u00a0<\/span>Sister (lymphocytes 6,000 CPM)<\/p>\n<p>\n<\/div><\/div>\n<p class=\"p2\"><span class=\"s1\"><em>Strategy<\/em>:\u00a0<\/span><span class=\"s1\">Item writers love to make questions look complex! A question like this becomes\u00a0<\/span>straightforward when you realize that rejection is the big worry in all transplants. When potential donor and recipient cells are mixed together, you would want the smallest number of lymphocytes, as it would indicate the least interaction between the cells. Therefore, the correct choice is D.<\/p>\n<p><div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h4  blockquote modern-quote  avia-builder-el-14  el_after_av_promobox  el_before_av_promobox  '><h4 class='av-special-heading-tag '  itemprop=\"headline\"  >Visualize the correct situation<\/h4><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div><br \/>\n\t<div   class='av_promobox  avia-button-no   avia-builder-el-15  el_after_av_heading  el_before_av_promobox '>\t\t<div class='avia-promocontent'><\/p>\n<p class=\"p4\"><span class=\"s1\">A convenience store clerk is hit in the face multiple times with a baseball bat\u00a0<\/span>during a robbery. Upon arrival at the emergency department, the patient is cyanotic and stridulous, with copious amounts of blood in his mouth. He has a markedly displaced mandible and midface, and clear fluid is draining from hi \u00a0nose. Two attempts at orotracheal intubation fail. Which of the following is the most appropriate next step in management?<\/p>\n<p class=\"p4\"><span class=\"s1\">A.\u00a0<\/span>Administer a high concentration of oxygen delivered through a tight-fitting face mask<\/p>\n<p class=\"p4\"><span class=\"s1\">B.\u00a0<\/span>Administer humidified oxygen and bronchodilator treatment<\/p>\n<p class=\"p4\"><span class=\"s1\">C.\u00a0<\/span>Intubate with a fiberoptic scope<\/p>\n<p class=\"p4\"><span class=\"s1\">D.\u00a0<\/span>Perform an emergency cricothyroidotomy<\/p>\n<p class=\"p4\"><span class=\"s1\">E.\u00a0<\/span><span class=\"s1\">Per<\/span>form a nasotracheal intubation<\/p>\n<p>\n<\/div><\/div><\/p>\n<p class=\"p2\"><span class=\"s1\"><em>Strategy<\/em>:\u00a0<\/span><span class=\"s1\">Visualization of stem information is critically important to getting more items cor<\/span>rect. If you picture what this patient\u2019s face must look like and what\u2019s already been tried, then choices A, B, C, and even E all seem unlikely to be successful. The only way to establish an airway with any certainty of success, thus keeping your patient alive for his other injuries to be treated, is choice D, which is the correct answer.<\/p>\n\t<div   class='av_promobox  avia-button-no   avia-builder-el-16  el_after_av_promobox  el_before_av_heading '>\t\t<div class='avia-promocontent'><\/p>\n<p class=\"p4\"><span class=\"s1\">A 27-year-old man is brought to the emergency department by paramedics\u00a0<\/span>after being thrown from the back of a pickup truck at high speed. He received 2 liters of intravenous (IV) fluid in transit. His pulse on arrival is 120\/min and BP is 60\/40 mm Hg. He is awake and without focal neurologic signs. He has a distended tender abdomen and a stable pelvis, with no deformities of the lower extremities. Portable chest x-ray results are normal. Which of the following is the most appropriate next step in management?<\/p>\n<p class=\"p4\"><span class=\"s1\">A.\u00a0<\/span>CT scan of the abdomen and head<\/p>\n<p class=\"p4\"><span class=\"s1\">B.\u00a0<\/span>Diagnostic peritoneal lavage and fluid administration while awaiting cell counts on lavage fluid<\/p>\n<p class=\"p4\"><span class=\"s1\">C.\u00a0<\/span>Dopamine infusion to improve BP, followed by observation<\/p>\n<p class=\"p4\"><span class=\"s1\">D.\u00a0<\/span>Exploratory laparotomy and administration of blood products<\/p>\n<p class=\"p4\"><span class=\"s1\">E.\u00a0<\/span>Spine films to rule out vertebral fracture<\/p>\n<p>\n<\/div><\/div>\n<p class=\"p2\"><span class=\"s1\"><em>Strategy<\/em>:\u00a0<\/span><span class=\"s1\">If you visualize this patient\u2019s injuries, it should be rather obvious that he is bleed<\/span>ing into the abdominal area because his blood pressure is still low (despite the IV) and his abdomen is tender and distended. This must be dealt with immediately or a rupture could kill him; there is no time for scheduling diagnostic tests (which rules out choices A and E). Choice C is clearly wrong because waiting and observing won\u2019t stop his bleeding. You would then guess either choice B or D. In considering these final two, it would probably be smarter to pick choice D (the correct answer) because choice B also mentions waiting for cell counts.<\/p>\n<p><div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h4  blockquote modern-quote  avia-builder-el-17  el_after_av_promobox  el_before_av_promobox  '><h4 class='av-special-heading-tag '  itemprop=\"headline\"  >Don\u2019t let sharp turns confuse you<\/h4><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div><br \/>\n\t<div   class='av_promobox  avia-button-no   avia-builder-el-18  el_after_av_heading  el_before_av_promobox '>\t\t<div class='avia-promocontent'><\/p>\n<p class=\"p4\"><span class=\"s1\">In recent years, most HMOs have instituted plans involving patient copayments.\u00a0<\/span>A local HMO has just raised copayments by $15 in an attempt to reduce costs. Studies have shown that the effect of increasing patient copayments in the United States has been which of the following?<\/p>\n<p class=\"p4\"><span class=\"s1\">A.\u00a0<\/span>Decreased utilization in direct proportion to the required copayment<\/p>\n<p class=\"p4\"><span class=\"s1\">B.\u00a0<\/span>Decreased utilization of unnecessary services only<\/p>\n<p class=\"p4\"><span class=\"s1\">C.\u00a0<\/span>Decreased use of tertiary services, but increased use of primary services<\/p>\n<p class=\"p4\"><span class=\"s1\">D.\u00a0<\/span>Increased utilization in a nonlinear fashion<\/p>\n<p class=\"p4\"><span class=\"s1\">E.\u00a0<\/span>Increased utilization in a linear fashion<\/p>\n<p>\n<\/div><\/div><\/p>\n<p class=\"p4\"><em>Strategy<\/em>:\u00a0<span class=\"s1\">This is a good example of what might be called a bait-and-switch question. The\u00a0<\/span>item writer is hoping that you\u2019ll assume the medical professionals\u2019 viewpoint so that you\u2019ll get slightly thrown off when the focus of the question is switched to the impact, not the intent, of increasing copayments. The correct answer is choice A, not choice B, because the typical citizen lacks the medical knowledge to know what is necessary and what isn\u2019t necessary. So he or she will tend to use less of all kinds of services.<\/p>\n\t<div   class='av_promobox  avia-button-no   avia-builder-el-19  el_after_av_promobox  el_before_av_heading '>\t\t<div class='avia-promocontent'><\/p>\n<p class=\"p4\"><span class=\"s1\">Malpractice insurance rates have continued to soar in recent years, adding to the\u00a0<\/span>overall cost of healthcare in the United States. It is recommended that physicians become more knowledgeable about this issue to exert peer influence on their medical colleagues. In this context, which of the following cases represents the best grounds for malpractice?<\/p>\n<p class=\"p4\"><span class=\"s1\">A.\u00a0<\/span>A 19-year-old model undergoes breast augmentation and is left with breasts of slightly unequal size.<\/p>\n<p class=\"p4\"><span class=\"s1\">B.\u00a0<\/span>A 27-year-old man dies from penicillin allergy after he receives a shot for strep throat in the emergency room.<\/p>\n<p class=\"p4\"><span class=\"s1\">C.\u00a0<\/span>A 51-year-old woman is diagnosed with breast cancer metastatic to her lungs. One month earlier, her mammogram was read as normal.<\/p>\n<p class=\"p4\"><span class=\"s1\">D.\u00a0<\/span>A 55-year-old businessman suffers peritonitis when operative sponges were not removed during his appendectomy.<\/p>\n<p class=\"p4\"><span class=\"s1\">E.\u00a0<\/span>A 77-year-old woman falls out of bed in the hospital and suffers a hip fracture.<\/p>\n<p>\n<\/div><\/div>\n<p class=\"p2\"><span class=\"s1\"><em>Strategy<\/em>:\u00a0<\/span><span class=\"s1\">This is another example of the bait-and-switch in the point of view. It tries to trap\u00a0<\/span>the test taker into evaluating the choices from the medical practitioner\u2019s viewpoint when in actuality, the question is asked from a malpractice attorney\u2019s viewpoint. Choice D is the correct answer because it\u2019s the only one that mentions any concrete physical evidence for the attorney to show a jury (the sponge). This makes it the easiest case to prove legally. Recognizing the point of view saves time and leads to fewer incorrect answers in questions like these.<\/p>\n<p><div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h4  blockquote modern-quote  avia-builder-el-20  el_after_av_promobox  el_before_av_promobox  '><h4 class='av-special-heading-tag '  itemprop=\"headline\"  >When in doubt, be open and empathetic<\/h4><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div><br \/>\n\t<div   class='av_promobox  avia-button-no   avia-builder-el-21  el_after_av_heading  el_before_av_heading '>\t\t<div class='avia-promocontent'><\/p>\n<p class=\"p4\"><span class=\"s1\">A 13-year-old boy with poor impulse control is brought to the office for an\u00a0<\/span>evaluation. During the interview, the boy expresses concern at his inability to control his temper, but he subsequently becomes enraged. With clenched fists and in a trembling voice, he tells the physician to \u201cStop bugging me or I\u2019ll hit you!\u201d Which of the following would be the physician\u2019s best response?<\/p>\n<p class=\"p4\"><span class=\"s1\">A.\u00a0<\/span>\u201cYou should never hit people.\u201d<\/p>\n<p class=\"p4\"><span class=\"s1\">B.\u00a0<\/span>\u201cDo you think you are really going to hit me?\u201d<\/p>\n<p class=\"p4\"><span class=\"s1\">C.\u00a0<\/span>\u201cIt must be frightening to be that angry.\u201d<\/p>\n<p class=\"p4\"><span class=\"s1\">D.\u00a0<\/span>\u201cI don\u2019t believe that you really want to hit me.\u201d<\/p>\n<p class=\"p4\"><span class=\"s1\">E.\u00a0<\/span>Sit quietly, watching the patient attentively but doing nothing.<\/p>\n<p>\n<\/div><\/div><\/p>\n<p class=\"p2\"><span class=\"s1\"><em>Strategy<\/em>:\u00a0<\/span><span class=\"s1\">Only choice C shows empathy with the boy\u2019s feelings. By not judging his behavior,\u00a0<\/span>the clinician encourages the boy to confide more information and avoids provoking him into further negative emotions. When encountering questions dealing with communication skills, always search for the answer that is most likely to lead to the patient saying more. This will usually be the most open-ended, nonjudgmental question or statement on the part of the clinician. Similarly, if the question deals with an ethical situation, it makes sense to search for\u00a0<span class=\"s1\">the choice that is most relevant or consistent with the ethical principle involved in the situa<\/span>tion, such as patient confidentiality or patient autonomy.<\/p>\n<p><div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h4  blockquote modern-quote  avia-builder-el-22  el_after_av_promobox  el_before_av_promobox  '><h4 class='av-special-heading-tag '  itemprop=\"headline\"  >Be wary of suspicion<\/h4><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div><br \/>\n\t<div   class='av_promobox  avia-button-no   avia-builder-el-23  el_after_av_heading  el_before_av_hr '>\t\t<div class='avia-promocontent'><\/p>\n<p class=\"p4\"><span class=\"s1\">A 52-year-old man with a 10-year history of hypertension complains of abdominal\u00a0<\/span>and back pain for the past 6 months, a 10-lb weight loss, and greasy, foul- smelling stools. He smokes 2 packs of cigarettes and drinks a pint of whiskey\/ day. On physical examination, he is afebrile with mild epigastric tenderness but no guarding, rigidity, or distension. Bowel sounds are present, and rectal exam is normal. Laboratory tests reveal the following:<\/p>\n<p class=\"p4\"><div class='avia-data-table-wrap avia_responsive_table'><table  class='avia-table avia-data-table avia-table-1  avia-builder-el-24  avia-builder-el-no-sibling  avia_pricing_default '  itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/Table\" ><tbody><tr class=''><td class=''>Hematocrit<\/td><td class=''>48%<\/td><\/tr><tr class=''><td class=''>Sodium<\/td><td class=''>141 mEq\/L<\/td><\/tr><tr class=''><td class=''>Potassium<\/td><td class=''>3.9 mEq\/L<\/td><\/tr><tr class=''><td class=''>Glucose<\/td><td class=''>148 mg\/dL<\/td><\/tr><tr class=''><td class=''>ALT, AST<\/td><td class=''>16, 24, respectively<\/td><\/tr><tr class=''><td class=''>Albumin<\/td><td class=''>4.7 g\/dL<\/td><\/tr><tr class=''><td class=''>Prothrombin time<\/td><td class=''>11 Seconds<\/td><\/tr><\/tbody><\/table><\/div><style type='text\/css'><\/style><\/p>\n<p class=\"p4\"><span class=\"s1\">Chest x-ray is normal, and abdominal plain film shows pancreatic calcifications.\u00a0<\/span>Which of the following is most likely responsible for his weight loss?<\/p>\n<p class=\"p4\"><span class=\"s1\">A.\u00a0<\/span>Alcoholic hepatitis<\/p>\n<p class=\"p4\"><span class=\"s1\">B.\u00a0<\/span>Duodenal ulcer<\/p>\n<p class=\"p4\"><span class=\"s1\">C.\u00a0<\/span>Gastric ulcer<\/p>\n<p class=\"p4\"><span class=\"s1\">D.\u00a0<\/span>Pancreatic insufficiency<\/p>\n<p class=\"p4\"><span class=\"s1\">E.\u00a0<\/span>Thiamin deficiency<\/p>\n<p>\n<\/div><\/div><\/p>\n<p class=\"p2\"><span class=\"s1\"><em>Strategy<\/em>:\u00a0<\/span><span class=\"s1\">People who have struggled to do well on multiple-choice exams often carry around\u00a0<\/span><span class=\"s1\">strong negative emotions about having to take these kinds of tests. Sometimes they feel that\u00a0<\/span><span class=\"s1\">the items are expressly designed to trick them into choosing wrong answers. Such feelings in\u00a0<\/span><span class=\"s1\">this case could easily lead the examinee toward avoiding answer D. The question stem lists\u00a0<\/span><span class=\"s1\">\u201cpancreatic calcifications\u201d; therefore, a suspicious test taker might reason that the pancreatic\u00a0<\/span><span class=\"s1\">calcifications clue was just to lure him or her into making a mistake. Wary test takers there<\/span><span class=\"s1\">fore choose another answer, the wrong one.\u00a0<\/span><span class=\"s1\">Notice also how the wrong answers each agree with at least part of the patient\u2019s findings.\u00a0<\/span><span class=\"s1\">The patient drinks heavily, so choices A and E relate to this fact. The patient has abdominal\u00a0<\/span><span class=\"s1\">symptoms, so choices B and C relate to those symptoms. In a well-written test, nearly every\u00a0<\/span><span class=\"s1\">incorrect choice fits at least some part of the stem information, but only the correct answer\u00a0<\/span>fits all of the clues given in the stem.<\/p>\n<p><div   class='hr hr-short hr-center   avia-builder-el-25  el_after_av_promobox  el_before_av_heading '><span class='hr-inner ' ><span class='hr-inner-style'><\/span><\/span><\/div><br \/>\n<div  style='padding-bottom:10px; ' class='av-special-heading av-special-heading-h3    avia-builder-el-26  el_after_av_hr  avia-builder-el-last  '><h3 class='av-special-heading-tag '  itemprop=\"headline\"  >Strategy Summary<\/h3><div class='special-heading-border'><div class='special-heading-inner-border' ><\/div><\/div><\/div><\/p>\n<p class=\"p4\">\u2022 Rely more on general recall and concepts.<\/p>\n<p class=\"p2\"><span class=\"s1\">\u2022\u00a0<\/span>Familiarity and life experience have validity.<\/p>\n<p class=\"p2\"><span class=\"s1\">\u2022\u00a0<\/span>Consider what\u2019s common versus what\u2019s rare.<\/p>\n<p class=\"p2\"><span class=\"s1\">\u2022\u00a0<\/span>Visualize what question stems describe.<\/p>\n<p class=\"p2\"><span class=\"s1\">\u2022\u00a0<\/span>Use homeostasis as a guide to what the body would try to do to keep a healthy balance.<\/p>\n<p class=\"p2\"><span class=\"s1\">\u2022\u00a0<\/span>Know important definitions.<\/p>\n<p class=\"p2\"><span class=\"s1\">\u2022\u00a0<\/span>Rule out extreme or unrelated choices.<\/p>\n<p class=\"p2\"><span class=\"s1\">\u2022\u00a0<\/span>Use decision rules to manage time use.<\/p>\n<p class=\"p2\"><span class=\"s1\">\u2022\u00a0<\/span>In items with tables, seek patterns.<\/p>\n<p class=\"p2\"><span class=\"s1\">\u2022\u00a0<\/span>In items with graphs, seek trends and anchor points.<\/p>\n<p class=\"p2\"><span class=\"s1\">\u2022\u00a0<\/span>Always seek relationships.<\/p>\n<p class=\"p2\"><span class=\"s1\">\u2022\u00a0<\/span>Use the whiteboard and marker to sketch or calculate.<\/p>\n<p class=\"p2\"><span class=\"s1\">\u2022\u00a0<\/span>Use logical analysis based on concepts and information given in the question.<\/p>\n<p class=\"p2\"><span class=\"s1\">\u2022\u00a0<\/span>Watch for hinge words in questions.<\/p>\n<p class=\"p2\"><span class=\"s1\">\u2022\u00a0<\/span>Develop a mindset to reject choices.<\/p>\n<p class=\"p2\"><span class=\"s1\">\u2022\u00a0<\/span>Look for the best fit with clues in the stem and with what you feel is the point of the question.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>What are the steps you should aim to incorporate into your approach to dealing with PANCE questions? They need to be generic enough to work with different kinds of questions. These steps also need to protect you from making mistakes that could hurt you. Let\u2019s look at the approach to questions used by many good [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":28849,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[371],"tags":[372],"_links":{"self":[{"href":"https:\/\/wpapp.kaptest.com\/study\/wp-json\/wp\/v2\/posts\/15004"}],"collection":[{"href":"https:\/\/wpapp.kaptest.com\/study\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wpapp.kaptest.com\/study\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wpapp.kaptest.com\/study\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/wpapp.kaptest.com\/study\/wp-json\/wp\/v2\/comments?post=15004"}],"version-history":[{"count":3,"href":"https:\/\/wpapp.kaptest.com\/study\/wp-json\/wp\/v2\/posts\/15004\/revisions"}],"predecessor-version":[{"id":34363,"href":"https:\/\/wpapp.kaptest.com\/study\/wp-json\/wp\/v2\/posts\/15004\/revisions\/34363"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/wpapp.kaptest.com\/study\/wp-json\/wp\/v2\/media\/28849"}],"wp:attachment":[{"href":"https:\/\/wpapp.kaptest.com\/study\/wp-json\/wp\/v2\/media?parent=15004"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wpapp.kaptest.com\/study\/wp-json\/wp\/v2\/categories?post=15004"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wpapp.kaptest.com\/study\/wp-json\/wp\/v2\/tags?post=15004"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}