Nursing School Exams: What Kind of Questions to Expect

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A lot of things in nursing school are stressful. However, probably one of the most stressful is the nursing school exams – specifically multiple-choice questions.

Multiple-choice questions are the foundation of every nursing school and the NCLEX exam.

And, in order to master multiple-choice questions, you need to understand multiple-choice questions. This article gives an explanation of nursing school exams and what kind of questions to expect.

The Nursing Process.

The first step is to understand the nursing process. As a nurse, you will need to be a problem solver to meet the healthcare needs of your patients.

And certainly, the nursing process is a tool used by nurses to solve those problems. Therefore, nursing school exam questions are designed to test the nurse’s ability to use the nursing process through multiple-choice questions.

The nursing process is also referred to as ADPIE. This is an acronym for the five steps of the nursing process. The steps include assessment, diagnosis, planning, implementation, and evaluation.


Assessment is the collection of data to determine the patient’s actual or potential health problems. The nurse gathers objective and subjective data.


Once the assessment is complete, the nurse analyzes, organizes and summarizes the data collected. Then, the conclusion of this data is written into a specific statement called a nursing diagnosis.

A nursing diagnosis is a specific statement of a health problem. Consequently, this is a health problem that the nurse is able to treat.

Nurses use a specific list of nursing diagnoses developed by the NANDA International (North American Nursing Diagnosis Association) formerly known as just NANDA. Most importantly, this organization provides the specific language used for nursing diagnosis.


The third step of the nursing process is planning. During the planning stage, the nurse sets goals and priorities. Therefore, the nurse plans interventions to anticipate the need of the patient.

During this step, the nurse identifies the need for collaboration with other disciplines. After that, the plan of care is specific to each patient.


During the implementation step, the proposed plan for nursing care is carried out.

The implementation step may involve the nurse, patient, family member or a member of a collaborative team. Moreover, the goal of implementation is to resolve the nursing diagnosis.


Evaluation is the final step in the nursing process. During this step, the nurse determines the patient’s response to the nursing interventions and determines if the nursing diagnoses were accurate.

Levels of Multiple Choice Questions.

Nursing school exams mainly use four of the six cognitive levels for multiple-choice questions. And, these levels include knowledge questions, comprehension questions, application questions, and analysis questions. These cognitive levels are a part of Bloom’s Taxonomy.

Level I Knowledge

Knowledge questions are the most basic and test your memory of information you have previously learned. Also, a knowledge question requires that you know such things as nursing terminology, abbreviations, and values.

Level II Comprehension

Comprehension question requires that you understand the information. Not only will you use the information committed to memory in the knowledge questions, but you must organize, translate and interpret that information.

Level III Application

Application questions required that you have the ability to utilize the information. Therefore, with this level question, you must take the knowledge you have comprehended and apply it to a specific situation.

Level IV Analysis

Finally, an analysis question requires that you have the ability to take a variety of data and recognize the interrelationships among this data.

Multiple Choice Question.

Multiple Choice Questions

A multiple-choice question contains the stem and answer options. The answer options normally include the correct answer and three distractors.


The stem is the initial part of the multiple-choice question. It presents the problem or asks the question. The stem can be positive or negative. Positive stems are concerned with what is true and negative stems are concerned with what is false.

Remember, negative stems contain words such as not, never, except and contraindicated. Therefore, these questions can trip you up if you do not read them carefully.

The Answer Options

The answer options contain all the possible answers to the stem. There are normally 4 answer options. So, one of the answer options is the best response or correct answer. Therefore, the other answer options are distractors.

Tips for Answering Multiple Choice Questions

  1. Always read the entire question
  2. Use the process of elimination to narrow your choices
  3. Select the best answer
    For more tip on test-taking read 10 Tips for Test-Taking in Nursing School

Alternative Item Format.

Alternative Format Questions

A great resource to learn about nursing school exam questions is the website. So, you should really familiarize yourself with this website.

Although most students go to this website right before NCLEX, this is a good place to start learning how to answer these types of questions. After all, nursing school questions are preparing you for the NCLEX.

NCLEX testing and a lot of nursing schools are beginning to use alternate item formats. For that reason, the website defines these types of questions below.

An alternate item format is an exam item, or question, that uses a format other than standard, four-option, multiple-choice items to assess candidate ability. Alternate item formats may include:

Multiple response items

Multiple response items may require a candidate to select a single correct response, have more than one correct response, or require all responses to be correct regardless of the number of possible responses

Fill-in-the-blank items

Fill-in-the-blank items that require a candidate to type in number(s) in a calculation item

Hot spot items

Hot spot items that ask a candidate to identify one or more area(s) on a picture or graphic

Chart/exhibit format

Chart/exhibit format where candidates will be presented with a problem and will need to read the information in the chart/exhibit to answer the problem

Ordered response items

Ordered Response items that require a candidate to rank order or move options to provide the correct answer

Audio item format

Audio item format where the candidate is presented an audio clip and uses headphones to listen and select the option that applies

Graphic options

Graphic Options that present the candidate with graphics instead of text for the answer options and they will be required to select the appropriate graphic answer

Any item formats, including standard multiple-choice items, may include multimedia, charts, tables or graphic images.

The NCSBN website has a great tutorial for alternative item format here:
Also, while you are there grab a copy of the NCLEX-RN Test Plan.

Disclaimer: The information contained on this site is not intended or implied to be a substitution for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained is provided for educational purposes only. You assume full responsibility for how you chose to use this information.

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