NP Practice Questions: Breaking Them Down to Build Up Your Score!

When prepping for your board exam, the focus should be on learning the content needed to be a safe and competent real-deal NP. But, no matter how much you study and feel prepared to pass that test (which you will!), there will always be NP practice questions that you’re just not sure how to answer. So, how can you break down a practice question to better understand it, and ultimately have a greater chance of answering similar questions correctly on your actual exam?

In this post, we’ll go over some strategies and logical reasoning to approach NP practice questions that are tripping you up and get the best score you can!

How to Break Down NP Practice Questions

1. Learn the anatomy of a question

No matter what the question is asking, every question has the same basic structure. There are really just two main parts: a stem and a lead-in.

Stem

The stem contains the details of the question, such as the clinical presentation, past medical history, and laboratory results.

Lead-In

The next part of the question is the lead-in which determines what you know (or don’t know) about the topic in the stem. Think of the stem as the story and the lead-in as the actual question.

Here’s an example!

A 43-year-old patient reports to the office with concerns of abdominal pain. The patient has obesity and hypertension. The patient reports pain on the right upper side of their abdomen most often after a large meal and the pain has been more consistent over the past several weeks. What is the most likely diagnosis?

In this example, the stem consists of the story, or the background information, such as the patient’s symptoms. The lead-in is the actual question “What is the most likely diagnosis?”

Don’t let super long questions stress you out! Most board questions are three sentences or less. But if you feel caught up in a longer question, look at the lead-in first, and then the rest of the question. Once you can focus on what the question is actually looking for, then you can move forward with trying to answer it. 

2. Identify key words

Another tip to answer board-style questions is to look for the key words. 

What seems to be emphasized?

What is the theme of the question? (sign or symptom, management, diagnosis, prescribing, etc.). Rule out any choices that don’t fit with the theme of the question.

Is there a focus on prioritization? So, if more than one answer choice is technically correct, which one takes priority?

Are there any details that are mirrored in the stem and the answer choices?

Here’s an example!

A 58-year-old patient with a history of heavy alcohol use and previous psychiatric hospitalization is confused and agitated. They speak of experiencing the world as unreal. What is the term for this symptom?

A) Depersonalization
B) Derailment
C) Derealization
D) Focal memory deficit

This question uses the term “unreal” in the question stem, and “derealization” is the correct answer!

Make sure you don’t miss any key words!

Sometimes when we get caught up in stress and anxiety, we miss words the first time we read a question. Slow down your reading speed, take a few deep breaths, and then re-read the question looking for key words.

3. Look for absolutes and contraindications

Here’s another quick way to rule out incorrect answers. Very few things in nursing and medicine are hard and fast rules. So, if you see answer choices with terms like “only,” “always,” or “never,” there’s a really good chance that those choices aren’t correct.

Also, if you notice two answer choices that are opposites (like hypothyroidism and hyperthyroidism), then chances are the correct answer is one of those and the other choices are distractors.

So, when you have to choose between those two answers, look back at the lead-in for what the question is asking and see if the stem provides any additional clues. 

4. What answer is most appropriate and realistic?

Another approach to helping choose the correct answer is to look for the choice that is most appropriate and realistic. For example, the FNP exam is primary care focused. If there’s an answer choice that’s outside of the scope of practice (like IV meds or a particular advanced procedure) then that’s not the correct choice.

Similarly, is there an answer choice that would delay appropriate care? An example of that would be ordering outpatient testing on a patient who actually needs emergency treatment. This goes back to the ideas of patient safety, scope of practice, and prioritization.

Final Thoughts

Taking your NP board exam is stressful, no matter how prepared you are. We hope you can use these test-taking strategies to help with your NP board exam success!

And of course, explore your options for Live Study Groups, Qbanks, courses, and more at SMNP Reviews! We’ll prepare you with the right tools to pass your NP board exam with flying colors. 💜

Looking for more (free!) tips from real-deal NPs to help you prep for your NP boards? Check out these other posts on the SMNP Reviews blog:

• Test Your Knowledge with These FREE FNP Practice Questions!
• How to Choose the Perfect NP Board Review Option for You
• 13 Do’s & Don’ts for Your NP Board Prep