Exit Exam Blues?
Alright, so you’ve spent years of your life making it through nursing school one breakdown exam at a time. You’ve done the pharm thing, you’ve massaged a million funduses, you’ve figured out the difference between PAWP and CVP, and now it’s time for the final exam. Like THE final exam. For all of nursing school.
The exit exam.
One of the questions that I get most commonly (over on my instagram…let’s be friends!) is “how do I study for [insert thing here]?” And the thing no one wants to hear is: you study for it the same way you study for everything. By studying every single day, avoiding marathon study sessions, using practice tests, and remediating your weak areas. No, seriously. That’s it. For all of nursing school. For the NCLEX, too.
Everyone wants there to be a magical answer, where I say “use this resource and you’re guaranteed to pass,” but that’s just not how it goes. Success on your exams comes from consistency, repetition, hard work, dedication, and just DOING it. No matter what you do, you’ve got to do something if you want to be successful. If you want to read about some of the strategies I employed when studying in nursing school, you can check out a post I wrote ages ago here. It all still applies. And when you’re done reading that, go read my blog about studying for ATI proctored/CMS exams. Every single thing I wrote there applies to studying in general, too, except you may need to sub in other resources if you’re not studying for an ATI exam. But let’s break it down a little bit more. And please keep in mind: although this is written specifically for the exit exam, this study strategy applies to studying for absolutely any nursing course and for the NCLEX, too.
Without further ado, here is my advice for studying for the exit exam (or the final comprehensive predictor, or whatever else your school calls it):
The exit exam covers everything you’ve ever learned in nursing school. You know what else does that? The NCLEX. So take this exam seriously, because you’re not just prepping for the exit exam, you’re prepping for NCLEX.
Start by gauging your performance where you are in this exact moment, without studying first. This means that I want you to take a practice exam. Whatever exit exam your school uses, it is very likely that they are also having you use some kind of a test prep service as well. Maybe that’s Board Vitals, Virtual ATI (VATI), or ATI’s Learning Systems. Maybe it’s UWorld or Hurst or Kaplan or My Mastery or literally anything of that nature. I don’t care what it is, they’re all going to provide the same service more or less. If your school does not provide you access to some sort of a test bank, then you need to get one now. You need to use a test bank to prepare for the exit exam, and you need to use a test bank to prepare for NCLEX. Full stop. Again, I don’t care which test bank, but you need one. I used UWorld, but choose whatever fits into your budget.
Find out how many questions your exit exam is going to be, and use your test bank to take an exam of the same length. If you’re going to be taking 180 questions for the exit exam, it’s time to start preparing your stamina to handle 180 questions. Select all subjects, all difficulty levels, and then get going. Treat it like the real thing: don’t look at your phone, don’t look up the answers, just take the exam.
99 out of 100 times, I tell you to take practice exams in “study” mode so you can read the full rationales, immediately see if you got the question right, etc. but for this very first “baseline” exam, I don’t want you to do that. Just take the exam like it’s the real thing. Read each question 3 times before you answer, try and answer the question before you see the options provided, and prove to yourself that your answer is correct before moving on.
Since you’re reviewing stuff you haven’t even thought about in literal years, you’re not going to be great at everything. You may get a truly garbage score on this first exam. DO NOT LET THIS GET IN YOUR HEAD. The point is to get the terrible scores out of the way now so that you can focus on your weak areas, study, and go on and slay the real thing.
Once you have finished the exam, I want you to now go back and review it. This is where you’re going to read the full rationale for every single question—even if you got it right—but I also want you to do something else: start making a remediation list. I suggest doing this in Google docs or Word or the notes app on your phone so that you can edit it as you go along. I also suggest continuing to use this list as you NCLEX prep. It doesn’t matter where you keep it, but since this is going to be your remediation list all the way until NCLEX, don’t lose it. I want you to write down every single thing you missed. Don’t write down the whole question or anything, but for instance: if you missed a question about the care of a patient receiving brachytherapy, I want you to write “brachytherapy” on the list. If you missed a question about what side effects to anticipate for a patient taking lisinopril, I want you to write “ACE Inhibitors: Lisinopril” on your list. Write down every single thing you missed on the list like this. If you missed a question because you didn’t read it fully, but you actually know the answer, don’t bother writing it on the list. This is for stuff you genuinely don’t know at all. I also suggest writing down the date that you missed it. In the future, you can add another date if you miss that content again, and you can easily see what stuff really needs further remediation.
Now, ignore that list for the rest of the day. You just took a million test questions, and it’s time to go rest and do something fun to give your brain a break.
It’s the next day! Hooray! Now comes the remediation. Look at your list, and just start at the top. THIS IS THE IMPORTANT PART. You are absolutely not going to go crack open a textbook and just start reading it. Any time you try to just read a textbook, I want you to imagine me spraying you in the face with water and shouting “NO!” We don’t do that here. Your brain will not read black words on a white page and learn a single thing from it. Sorry. It’s just not going to happen. Here’s what we’re going to do instead: ***You’re going to bookmark the link to my Nursing School Resource Masterlist, and you’re going to use that to help you pick fun and engaging study tools.*** You’re going to pick a topic on your list and find some great way to study that content. You need to remediate lisinopril? Cool, why don’t we use the Level Up RN pharmacology flash cards while watching Cathy Parkes break down antihypertensive drugs on youtube. Or we can read the Level Up RN blog post about antihypertensives to get a review that isn’t written in eye-crossing technical jargon. Or maybe you’re more into writing things down, and you want to write down everything you need to know about lisinopril on an active learning template. Awesome! Or perhaps you’d like to listen to the Pharmacology Mastery podcast or the Straight A Nurse podcast. Fantastic! I don’t care what it is, but do something to review that content in a way that interests you.
Once you feel confident that you’ve fully reviewed that content, go ahead and check off the box corresponding to the date I missed the question. So if you took the exam on 8/6 and missed that content, and then remediated it on 8/7, check the box that says “Missed: 8/6” so that you can see that you have remediated that content from that exam.
Now, lather, rinse, repeat. The following day, I want you to take another practice exam. It doesn’t have to be 180 questions again, but I would suggest doing no fewer than 50 questions, but I would really suggest aiming for 75-100 questions from here on out until NCLEX. You’ve got to get used to sitting for big chunks of questions. Take the exam (in study/practice mode now, that’s fine), read the full rationales, and write down every single concept you missed on your remediation list. Let’s say you missed a question on brachytherapy again…I want you to write the date you missed it under the original brachytherapy heading. You want to be able to quickly tell at a glance what stuff you’re missing over and over.
Then, remediate that stuff the following day. Are you sensing a pattern here? Good! We take the practice exams on one day, and we remediate them the following day. I cannot say this enough: you need to remediate the stuff you missed within 24 hours, but do not remediate it on the same exact day you took the exam. Similarly, I do not want you taking practice exams every single day! We need to give our brains a break, digest the information, and mix up the format of stuff we’re doing. If we try to do 75 practice questions every single day, our brains will revolt. If we try to remediate the same day as the practice exam, our brains will revolt. Give your brain the time it needs to think through everything it just learned and to rest.
Listen, I know this seems obvious, but I’m going to say it: do not study the things you are getting right. I know, I know, you’re rolling your eyes and thinking “duh, Meris, obviously.” But it’s not so obvious. We like studying the things we know already because it gives our egos a nice boost. When I can recite a Level Up RN flashcard verbatim, I feel good about myself. But if you already know the information, you are wasting your time by studying it. Force yourself to be uncomfortable by only studying your weak areas.
Another thing I think is obvious, but might not be: let’s say I missed lisinopril and I remediated it by watching that Level Up RN video while looking at the corresponding flashcards. I then miss another question on lisinopril. Don’t remediate it by doing the same thing again. This time I might go read that Level Up RN blog, or work on an active learning template, or listen to a podcast. But don’t do the exact same thing you did to remediate the first time. Clearly you need more remediation, so start throwing new resources at it!
One more thing: it’s okay to use practice questions as a way to study, too. I really liked practice questions when I was in nursing school, because I felt like it helped me to think critically, it helped me to understand how I might be asked questions on a topic, and it helped me to improve my test taking strategies/skills. So on the days following your comprehensive practice exams, it’s okay to use targeted practice exams to study if you want to. But I would be very specific with your intentions: look up “NCLEX style practice questions on ACE Inhibitors” or whatever—you need to be sure you’re studying the right stuff if you do incorporate practice questions. In my nursing school resource master list, I have links to books of practice questions that I really recommend. These are the Davis Success books, and they exist for each major area of study. This allows you to take practice questions based not just on subject (like pharmacology), but on specific chapters of that subject (like antihypertensives, or asthma medications, or whatever else!). Here are links to all of the books:
They also have a general Test Success book which I recommend to new nursing students & those wishing to improve their test taking strategies!
And…that’s it. I know I just threw a lot at you, and I know it seems daunting and overwhelming, but it’s actually super straightforward. We can sum it up pretty easily:
Practice test —> Read the rationales & write down the content you missed —> Remediate the content you missed by using engaging resources —> Practice test
And now, here are some examples of how your remediation list might look. But remember, do whatever makes sense to you and works with your life and study habits above all else.
This is an example of how I suggest setting up your remediation list. Write the topic, and underneath it write the dates that you missed it. I especially suggest using a checklist feature!
Here’s how your list might look after you remediate and take another practice exam. As you can see, I crossed off the topics I remediated on 8/7 from the first exam. Then I took another practice exam on 8/8, and added more topics that I missed. I like to highlight the content if it’s something I missed, remediated, and missed again so that it stands out and I can visually see that I need to remediate that topic again.
Questions? Comments? Let me know below :) And please, if you thought this was helpful, I would love for you to follow me on instagram and send a link to this blog to your nursing school friends and/or professors. My one goal for this blog and everything I post on instagram is to make nursing school as painless as possible. I share what I learned and what worked best for me in hopes that it can help make your life a little easier. If it does, please pass it on to other students you think could benefit from the knowledge as well!
Don’t forget to take your meds and stay hydrated. Happy studying!