Nursing Board Exam Tips O5: The Power of Elimination

October 19th, 2009 by Dianne Peña

I believe Multiple Choice is the hardest type of exam because you are given 4 seemingly similar choices that you need to analyze from. With that, I give you… The power of ELIMINATION.

Take note of the STRATEGIC words. When you are being asked about or when the question contains these words:

  • PRIORITY– Use the principle of ABC (Airway, Breathing, Circulation)
  • INITIAL- Use the principle of Nursing Process (Assessment, Diagnosis, Prioritization, Implementation, Evaluation)
  • MOST IMPORTANT– Use the principle of Maslow’s Hierarchy of Needs (Physiologic Needs, Safety Needs, Love and belongingness, Self-Esteem, Self- Actualization)
  • BEST- Look for the option that also speaks of the other options combined, universal, broader, general— the “Umbrella Effect”. At times, it is the longest option

Beware of the tricky phrases. Determine if it is a positive or a negative query. If it is positive, then select the positive option. If it is negative, then select the negative option. Here are some examples:



Which of the following…. is appropriate Which of the following…. inappropriate
The most appropriate response/action All of the following…. except
All of the above None of the above
Indicates understanding Needs further teaching

Eliminate the absolute and same words in an option. Some options have the same idea, which are definitely considered wrong, so erase them in you choice. The words “all, always, every, must, none, never, only” indicates fixed and extreme meanings which are usually incorrect. Options with “may, usually, normally, commonly, generally” should be considered as possible correct answer.

Take note of the subject in the question. The gender, age (developmental stage), disease condition or medication. Put it in a box because it is of big point for consideration. This tip is most effective when you are being asked on the action of a certain drugs—just refer to what type of disease and you’re good.

Often times, the correct answer is between the 2 opposite option. Example:

a. Low BP

b. High BP

c. High PR

d. Low RR

2 opposite option are letters A and B so most probably, the correct answer is between the 2.

Read all of the choices before choosing one. When you already eliminated all the possible wrong answers, you may probably be in a dilemma of choosing between the last 2 very similar options. When you do, re-read the question again, apply all the techniques, then if all else fails trust your instinct, call up to God and believe in the power of intelligent guessing.

That’s another round of tips. Hopes this would be of help, even just a bit. LOL!


Reference for some of the tips is Saunders NCLEX-RN book.

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3 Responses to “Nursing Board Exam Tips O5: The Power of Elimination”

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