Critical Thinking: Identifying the Keyword

Tips in Answering Nursing Local Board Examination Questions

Answering a multiple choice question can be easy yet confusing. Many nurses fail the board examination not because they do not have the knowledge or intellect (even those who graduated with honors still fail the nursing local board examination) but because they fail to practice and improve their test taking skills. I am not saying that you need not to study for the board exam; a very good theoretical foundation of nursing concepts is one factor to pass the examination. However, nursing licensure examination questions are most of the time presenting choices that theoretically we may think is applicable but only one option is the correct answer.

Importance of Keyword

You might want to skip the details and read on the latter part of this essay, but I encourage you to read the importance of keyword first. Most nurses neglect identifying the keywords because it seems so easy. However, though easy as it may seem once neglected, you will be directed to the wrong answer.

A tree has different parts, a root, trunk, branches and fruits. The keyword is like a root of a tree. Without the root, the tree will not survive. If the keyword is not identified, you will not get a correct answer. Always highlight, encircle or underline the keyword so that you will be guided in eliminating the choices.

Identifying the keywords

Common Keywords
Except, initially, apart from, needs further teaching, best describes, most appropriate, incorrect, correct, appropriate, first, best

The situation gives you the details of the question but frequently they are just misleading you. I am not saying that the situation of a question should not be given importance; it’s just that keywords will guide you through the correct option by having an idea of the situation. Let’s take a look at this question:

Anna is confined in a health care facility. One afternoon, she appeared to be listening to someone. The nurse approached Anna and asked, “What are you thinking about?” The patient responded by stating, “I am hearing a very loud voice.” There is no other person in the room except for the nurse and the patient and the nurse hears no voice. Initially, the nurse response should be which of the following?

  1. a. “I don’t hear any voices.”
  2. b. “What are the voices telling you?”
  3. c. “You seemed upset, are you trying to hurt yourself?”
  4. d. “Oh come on, you must be kidding me!”

The keyword of the question is INITIALLY. Basing on the situation given the client is hallucinating (auditory). Presenting reality is one of the management for hallucination, however because the question is asking for the nurse’s initial or first response the answer is to assess the content of hallucination to know if the voices are commanding the client to kill himself or others, thus safety precautions will be implemented. Therefore, the correct answer is Letter B.

Identifying keywords are very important to get the correct answer. Don’t neglect them. Highlighting a keyword means directing that pencil to shade the correct option.

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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