Eliminate Incorrect Answer Choices

Now that you’ve mastered rewording the question, let’s examine how to select the correct answer.

Remember the characteristics of unsuccessful test takers? One of their major problems is that they do not thoughtfully consider each answer choice. They react to questions using feelings and hunches. Unsuccessful test takers look for a specific answer choice. The following strategy will enable you to consider each answer choice in a thoughtful way.

Step 1. Do not look at any of the answer choices except answer choice (1).

Step 2. Read answer choice (1). Then repeat THE REWORDED QUESTION after reading the answer choice. Ask yourself, “Does this answer THE REWORDED QUESTION?” If you know the answer choice is wrong, eliminate it. If you aren’t sure, leave the answer choice in for consideration.

Step 3. Repeat the above process with each remaining answer choice.

Step 4. Note which answer choices remain.

Step 5. Reread the question to make sure you have correctly identified THE REWORDED QUESTION.

Step 6. Ask yourself, “Which answer choice best answers the question?” That is your answer.

Let’s practice the elimination strategy using the same questions.

THE REWORDED QUESTION: “What is good documenting?”

Step 1. Do not look at any of the answer choices except for answer choice (1). Thoughtfully consider each answer choice individually.

Step 2. Read answer choice (1). Does it answer the question, “What is good documenting for this situation?”

  1. “Six lesions in various stages of healing noted on buttocks.” Is this good documenting? Maybe. Leave it in for consideration.

Step 3. Repeat the process with each remaining answer choice.

  1. “Multiple lesions on buttocks due to child abuse.” Is this good documenting? No, because the LPN/LVN is making a judgment about the cause of the lesions.
  2. “Lesions noted on buttocks from unknown causes.” Is this good documenting? Maybe. Leave it in for consideration.
  3. “Several lesions noted on buttocks caused by cigarettes.” Is this good documenting? No. The question does not include information about how the burns occurred.

Step 4. Answer choices (1) and (3) remain.

Step 5. Reread the question to make sure you have correctly identified THE REWORDED QUESTION. This question asks you to identify good documenting.

Step 6. Which is better documenting? “Six lesions in various stages of healing noted on buttocks,” or “Lesions noted on buttock from unknown causes”? Good documenting is accurate, objective, concise, and complete. It must reflect the client’s current status. The correct answer is (1).

Some students will select answer (3), thinking, “How can I be sure about the stages of healing?” But the purpose of this question is to test your ability to select good documenting. Select the answer choice that shows you are a safe and effective nurse. Remember, questions on the NCLEX-PN® exam are not designed to trick you. Stay focused on the question.

Let’s select the correct answer for the second question.

THE REWORDED QUESTION: What is incorrect information about TB?

Step 1. Do not look at any of the answer choices except answer choice (1).

Step 2. Read answer choice (1). Does it answer THE REWORDED QUESTION, “What is incorrect (or wrong) information about TB?”

  1. “I will have to take medication for 6 months.” Is this wrong information? No, it is a true statement. The client will need to take a medication, such as isonicotinyl hydrazine (INH), for 6 months or longer. Eliminate this choice.

Step 3. Repeat the process with each remaining answer choice.

  1. “I should cover my nose and mouth when coughing or sneezing.” Is this wrong information about TB? No, this is a true statement. TB is transmitted by droplet contamination. Eliminate it.
  2. “I will remain in isolation for at least 6 weeks.” Is this wrong information about TB? Maybe. Leave it in for consideration.
  3. “I will always have a positive skin test for TB.” Is this a wrong statement about TB? No, this is true. A positive skin test indicates that the client has developed antibodies to the tuberculosis bacillus. Eliminate this choice.

Step 4. Only answer choice (3) remains.

Step 5. Reread the question to make sure you have correctly identified THE REWORDED QUESTION. The question is, “What is incorrect information about TB?”

Step 6. The correct answer is (3). You “know” this is the correct answer because you’ve eliminated the other three answer choices. The client does not need to be isolated for 6 weeks. The client’s activities will be restricted for about 2–3 weeks after medication therapy is initiated.

A couple of things to remember when using this strategy:

Here’s another question.

THE REWORDED QUESTION: What is true about antenatal betamethasone?

Step 1. Do not look at any of the answer choices except answer choice (1).

Step 2. Read answer choice (1). Does it answer the question, “What is true about betamethasone?”

  1. “As long as I receive my medication, I won't deliver prematurely.” Is this true about betamethasone? No. Betamethasone will help fetal lung maturation in case the client delivers prematurely, but it doesn't prevent premature delivery. Eliminate it.

Step 3. Repeat the process with each remaining answer choice.

  1. “It is important that I count the fetal movements for one hour, twice a day.” Is this true about betamethasone? Maybe. Clients are told to be aware of fetal movement. Keep it as a possibility.
  2. “I may have insomnia and a rapid heart beat while on this medication.” Is this true of betamethasone? Yes. Betamethasone is a corticosteroid. Side effects include insomnia, increased maternal heart rate, and hypertension. Leave this choice in for consideration.
  3. “Bed rest is necessary for the medication to work properly.” Is this true about betamethasone? No. Betamethasone will work whether the client is on bedrest or not. Eliminate it.

Step 4. Note that only answer choices (2) and (3) remain.

Step 5. Reread the question to make sure you are answering the right question. The question is, “What is true about betamethasone?”

Step 6. Which choice best answers the question, (2) or (3)? If you are focused on the question, you will select (3). Some students focus on the background information (pregnancy). This question has nothing to do with pregnancy. If you chose (2), you fell for a distracter.

Remember: Focus on the question, and not the background information. If you can answer the question—“What is true about betamethasone?”—without considering the background information (pregnancy), do it. Many students answer a question incorrectly because they don’t focus on THE REWORDED QUESTION. Don’t fall for the distracters.

At this point you’re probably thinking, “Will I have enough time to finish the test using these strategies?” or “How will I ever remember how to answer questions using these steps?” Yes, you will have time to finish the test. Unsuccessful test takers spend time agonizing over test questions. By using these strategies, you will be using your time productively. You will remember the steps because you are going to practice, practice, practice with test questions. You will not be able to absorb this strategy by osmosis; the process must be practiced repeatedly.