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Ep #12: Exam Day Anxiety [NP STUDENT]

Graduation season is starting to roll around again, and it’s got me reflecting on my own board exam experience. The self-doubt and panic that can arise often feel challenging to navigate, so I feel really called today to share some solid ways to address and squash your exam day anxiety because I know every single one of you have the capacity to pass your exams with flying colors. 

The truth is that half of what it takes to pass is great content preparation, and the other half lies in cultivating anxiety management. I know y’all have nailed the first half, so my goal this week is to help you calm those jitters to go in with ultimate confidence. 

To those of you who might be experiencing exam day anxiety right now, I want you to know that I see you, I feel you, and I was you not too long ago. I’m here to show you that you can absolutely do this, share lessons I learned from when I was in your shoes, and give you 4 concrete steps to overcome exam day jitters. 

To celebrate the launch of the show, I’m giving away a Medelita gift card to two lucky listeners who subscribe, rate, and review the show on Apple Podcasts or iTunes so you can go get yourself a gorgeous white coat when you’re ready. Click here to learn how you can enter to be eligible to win one of these gift cards!

What You Will Discover:

  • 4 concrete steps to overcome exam day anxiety. 
  • How you can overdo your board preparation and why you want to avoid this.
  • What helped me the most when I was in your shoes. 
  • How I inadvertently fed my anxiety and self-doubt before my exams. 

Featured on the Show:

  • Enter for your chance to win a Medelita gift card to buy yourself a gorgeous white coat when you’re ready!

Full Episode Transcript:

Welcome to Becoming a Stress-Free Nurse Practitioner, a show for new NPs and students that want to pass their board exam the first time and make that transition from RN to NP as seamless as possible. I’m your host Sarah Michelle. Now, let’s dive into today’s episode.

Hello, all my friends, especially those of you who are graduating soon or have recently graduated. Today I feel really called to share with you guys some solid and concrete ways to address your exam day anxiety and what that can really look like. Please feel free to use this episode to learn from my own board preparations mistakes and how I inadvertently fed my anxiety before my own exam.

For those of you already in my review courses or in my student communities, you know how much I harp on anxiety and how I feel like anxiety management is such a critical piece of not only board preparation, but truly your transition into the practice someday too. I firmly have always believed that passing your exam is twofold. Half of it is great content preparation. And the other half of it is some really great anxiety management.

I’ve been doing so much reflection in these last few weeks about how I was feeling before my own exam, as this May time graduation season is definitely starting to roll around again. And beyond just that I have been ultimately reflecting a lot on why I started creating board review courses in the first place.

So this episode, in a lot of ways, is really from my heart to yours to say I see you, I feel you, and I have been you not that long ago. And truly, I want to help you see that you do have the ability to do this, as I wholeheartedly believe every person out there who finishes nurse practitioner school has the capability to pass their exam. You just have to start the journey to believing that fact for yourself, which we are definitely going to get into through this episode in four solid steps.

Now before we get into those steps together, I have to include the caveat that having some exam day jitters is totally normal. I promise. I felt for me my exam anxiety was something a lot in those final weeks before my exam that I was trying to stuff down and almost hide. But in this last year of my review courses I have been able to fully see what a universal feeling this is among those who are graduating.

So I’m here to tell you, you are not alone. Especially those of you graduating during COVID times where you lost a lot of those final clinical hours or had to delay your plans or delay your graduation. You already have that extra COVID anxiety on top of taking your certification exam and it can be super easy to start to spiral and ask yourself questions like, have I learned enough, have I prepared enough, et cetera.

Therefore I want to tell you first and foremost, you do know enough because you never would have graduated nurse practitioner school if you didn’t. You have all of the content knowledge that you need to go and take that exam because, guys, you’ve spent the last two to five years learning it.

The difference is learning how to have the confidence in that knowledge that you already have. Having awareness and space for that fact alone, that you do have this content knowledge somewhere in your brain is really your first baby step into squashing down some of that exam day anxiety.

And now that you’ve taken your first little baby step with me, let’s get into some real guidance for what I felt like helped me the very most when I was in your shoes.

So for step one, I want to ask you to pause and reflect on why you are doing board preparation. That might sound like a weird question but getting specific with your why is really important for the steps to come and bringing down the anxiety that you’re currently feeling. Technically, you could graduate, not take a single review course, not do a single practice question, and go ahead and take your exam next day.

But I know that for me as a new graduate about to take boards I was searching desperately for something that brought me assurance and confidence. In my eyes the purpose of doing any sort of board prep is so that you can dampen down your anxiety, highlight what you know, and fill gaps in areas that you’re weaker in so that you can log into your exam feeling as prepared and as good as humanly possible. That should really be your big overarching goal throughout this process.

And the reason I bring up your why is to say to you, if there is something in your study plan that is not accomplishing that goal, that is a surefire way to feed your anxiety and ultimately all those negative thoughts of self-doubt that we were just talking about. That means it’s time for you to take a step back from the inner workings of your board preparation and dig deep to write out all the things you are currently using and delete whatever may be in your plan that is not contributing to that goal.

For example, for me there was one question bank that I was given for free that had fantastic questions when they asked about primary care. But the primary care and the acute care questions were all mixed in one. So I became super overwhelmed when those acute care questions started popping up and I didn’t know the answer.

And while that may sound a little crazy because I knew my exam was not going to ask me any acute care questions, that question bank was leaving me feeling unsure and overwhelmed every time I left the software. Those questions fed my anxiety over and over. And so finally, three weeks before my exam I just quit using that software all together.

I heavily encourage you to start right here and write out everything you are currently using. Even pause this podcast If you have time and see if there’s anything that needs to be deleted. Because the sooner you delete whatever it is that’s only contributing to your anxiety, the better you will feel overall about yourself and ultimately about your exam.

Which brings me to a little side point as well. I highly suggest choosing one or two review courses to stick with leading up to your exam. I know that when you’re anxious like I was it can be easy to buy five review courses.

Y’all, the panic buying is so real, but it’s also so not necessary. So please learn from my own board preparation mistakes because I’ve found time and time again with my students that once you add on more sources than two for content you enter into this state of overwhelm.

And that’s because every review course out there is going to teach and offer content differently. With those differences it’s as if students enter into this guessing game of who do I listen to? Then students feel like they’re not ready when they really are because they’re spending time obsessing over the nitty gritty.

The exams don’t typically care about the nitty gritty. Instead the exams care about making sure that you have the baseline knowledge base to be safe in practice. If you’re one of those people out there listening right now who, like me, was panic buying review courses, please save your brain some misery and choose two of those today and throw out the rest. We really want to be constantly striving to combat overwhelm instead of contributing to overwhelm. That is honestly the harsh truth that I wish someone had said to me in those final weeks.

But to get back on track a little bit with our steps, once you figured out your why, deleted out anything you’re using that’s not working, and chosen some solid reviews to stick to, no more than two, then we can move on to step two. Which is creating your plan.

And for some of you out there, you may already have a plan. But I want to push you to revisit that plan. Look at it again and figure out for yourself do you truly have a solid plan that includes not only your study time but also your break time? Do you have it written down so that you’re committed to it?

How you approach your board preparation will ultimately impact how you feel overall on exam day. A great way to bring down that anxiety you’re feeling is to have it all laid out with at least two break days per week. You cannot do this all day, every day, guys. It’s just not going to stick.

We really want to come back to that concept of quality over quantity. So studying 12 hours a day for weeks on end and frazzling your brain is not going to be as effective as studying two to four hours per day and incorporating that break time. Because guys, there is absolutely 100% such a thing as overdoing your board preparation.

And I know that firsthand because I’m the queen of overdoing it. If you couldn’t figure that out from all the review courses I bought, and most of which I didn’t even end up using fully. And that overdoing it led to me making myself physically sick in the weeks leading up to my exam. My poor husband didn’t know what to do with me in those final few weeks where I literally felt like my hair was falling out and I was obsessed over my studying.

But the thing is, guys, you can take breaks and still pass. I tell this to students all the time. You do not have to commit every waking moment to this exam, you just need a solid schedule and some dedicated time. Those break days will give you that breath of air and life that you need to make your next study session even better than the last. So not only should you take your breaks, but you should also enjoy your breaks as well. Those two things are equally as important.

All right, so step number three is gathering your list of tangibles. I am always talking to my students in my Facebook community about having tangible items they can refer to in order to give themselves the mental boost to say, “I have adequately prepared for this exam.” Just having that reference point alone is a great way to dampen down that self-talk again when you’re feeling anxious and starting to catastrophize.

For me, my list of tangibles include all the board review courses I had completed, but it more importantly included all of the practice questions I had completed too. I literally did thousands of questions before my exam to give myself a true number and score to hold on to for exam day. Whenever I started to self-doubt, I would say, “Sarah, you’ve done thousands of practice questions and you’re scoring at X percentage here. You know that you know your content.” I would affirm myself over and over with that tangible list, even when I got into the exam itself.

Having those tangibles really gave me the peace of mind to take a breath during those tougher exam questions. It allowed me to search my brain and try to find a similar practice question to what I was seeing on my exam.

That’s part of why practice questions themselves can be such a cornerstone of your study, because there are truly only so many ways to ask a question and you are so likely to see something similar on your exam if you do enough of them. What an advantage to have and that’s why I recommend on my page completing at least a couple thousand practice questions, if you can, before taking your exam.

And your last step, step four comes during the week leading up to your exam. Y’all, y’all want to be feeling good that week. That last week you want to feel as good as you possibly can. The way that you feel good and dampen down that anxiety in those final days is to do whatever it is from your studying process that makes you feel your very best. Only you will know what will make you feel your very best.

For me, especially because I didn’t personally feel like any of the courses I had purchased brought me that relief, and assurance, and ultimately confidence that I had been searching for, I routinely came back to my practice questions. I rebooted all of my apps in that last week and started fresh to see where I was scoring at. At that point I had done those questions so many times I was scoring well above 90%. And deep in my heart I knew I was ready to conquer this exam.

Even though I knew that I was nervous, I was ready to get it over with. I wanted it behind me. That is the place that you want to aspire to be before testing, nervous but over it. And the reason you’re over it is because you know the work that you put in. It’s plain and simple guys, hard work and anxiety management are the dream team to passing your board exam.

So to tie this up, from my heart to yours, once again look at why you’re doing more preparation and delete whatever it is that’s not helping you meet that goal. Make a true plan and stick to it. And take those beak days just like we talked about. Write down your list of tangibles and have that in a concrete place to refer back to when you’re needing it, because you’re going to need it. And then spend that last week or so really boosting yourself to the very best of your ability by revisiting the highlights of your studying process.

And then your extra bonus tip, if you’re one of my students is to listen to my day of exam pep talk in the parking lot, just before you walk into the testing center when you’re going to be feeling your most anxious of all. I want to boost you with that tiny pep talk into the very best spot that you can be.

And then I want you to walk into that exam with the confidence that you will slay your exam. Because the reality is that you guys don’t have to know everything. When there are exam questions that are super tough, no big deal. Because you know that you only need to know around 70% of the exam to pass.

That gives you guys so much leeway, which is another tool that you can use for yourself to bring those anxiety levels down. Because no one expects you to know at all, not for your boards and definitely not for practice.

Your board exam truly just needs to ensure that you’re going to be competent enough to safely practice. And the thing is, we both know that you have that knowledge base already if you’ve graduated from nurse practitioner school.

So I want to finish out this quick little episode by saying I’m rooting for you and I have confidence in you that you can do this. You are capable, you are deserving, and you have truly put in all the hard work to be here. If you feel like you’re struggling on the anxiety front feel free to join the student Facebook community if you haven’t already and bounce your plan and your thoughts off of the other students in the group and off of me as well. I’m always happy to help you along in this process in whatever way I can. And I’ll talk to you soon my friends.

Now, to celebrate the launch of the show, I’m going to be giving away a Medelita gift card which will allow you to go buy a gorgeous white coat when you’re ready. Now, I’m going to be giving away a gift card to two lucky listeners who subscribe, rate, and review the show on iTunes. It doesn’t have to be a five-star review, although I really do hope you love the show. I want your honest feedback so I can continue creating a show that provides tons of value for you guys as nurse practitioners.

Visit to learn more about the contest and how to enter. And I’ll be announcing the winners on the show in an upcoming episode.

Thanks for listening to Becoming a Stress-Free Nurse Practitioner. If you want more information about the different types of support we offer to students and new NPs visit See you next week.

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