On the NREMT exam, you should make efforts to eliminate answer choices to narrow down your options. If you end up having to select between two options, try these tips:
Reread the stem once more just to make sure that you didn’t miss any subtle clues.
Sometimes the best answer is the longest one or the one that has the most specificity. This is not likely to happen with the NREMT exam because they check for such item-writing “errors,” but you never know.
A test item may ask you a sequencing question — what you should do next, for example. If you’re trying to choose between two answers, look to see whether there’s an order to how things should happen. For example, does Choice (A) happen before Choice (B)?
You can apply a “true-false” test to the answer choices. Reread the stem with each answer and ask yourself whether it sounds true or false. Your intuition is your subconscious mind speaking to you. You may have learned the information, but it may not be coming to the surface.
Rereading the stem and answer together may allow your subconscious to match a learned nugget that you’re unable to recall at the moment. If more than one answer rings true, check to see whether there’s a sequencing component.
Sometimes two of the four choices are opposites of each other. If so, there’s a good chance that one of them is correct.
A 19-year-old male has been shot in the chest. He has an open wound to the left anterior chest wall that is oozing blood. He responds incomprehensibly to verbal stimulus. His respiration rate is 8, with shallow breathing. His pulse rate is 110, and his skin is cool, pale, and diaphoretic. What should you do first?
(A)Insert an oropharyngeal airway.
(B)Ventilate with a bag-valve mask (BVM).
(C)Apply gauze to the open chest wound.
(D)Administer high-flow oxygen with a nonrebreather mask.
You might want to select Choice (D) because it’s the longest answer, and it certainly seems that the patient requires oxygen. However, his breathing rate is slow, and his tidal volume is shallow. These facts point more to Choice (B) as a better answer. While he is altered, he does respond to a verbal stimulus, which may mean he has a gag reflex.
This consideration makes Choice (A) less of a good answer. If Choice (C) were to apply an occlusive dressing to the chest wound, that would make it a very good answer. But applying gauze alone makes this a poor choice as air could still pass through the wound.
If you follow these tips, you’re making an educated guess on questions to which the answer isn’t clear. This tactic is very different from performing a WAG — a wild-!ed guess. WAGs are simply playing the odds and hoping that you end up choosing the best answer. Educated guessing is really applying the skill of deduction, which increases your chances of being correct.
