Studying for application-level exams requires a different approach than studying for exams that test mainly recall or knowledge of facts. Not only must you know definitions and concepts, but you have to understand how to use or apply these concepts to different scenarios. It is important for the learner to be aware of gaps between topics on the exam.

The learner should also be intrinsically motivated and interested in their own learning. The learner maintains their own accountability (Sebesta et al., 2017).

Here are some tips for studying for application-level exams:

1. Understand the concepts: Application-level exams are designed to test your understanding of concepts, not just your ability to recall information. Make sure you have a solid understanding of the concepts being tested. Try to connect new information to what you already know, and use examples to help you understand how the concepts work in practice.
2. Practice problems: To succeed on application-level exams, you need to be able to apply the concepts you’ve learned to solve problems. Practice as many problems as you can, and try to solve them without looking at the answers. This will help you identify areas where you need more practice and build your confidence. You can purchase an NCLEX study book at your local bookstore or online. These come with thousands of practice questions for your review. Alternatively, you can do a Google search for Practice NCLEX questions + renal system (insert the topic you are studying here).

1. When you take practice questions, you can find your studying gaps

1. Take 15-20 each night. Then look up why you got the questions wrong that you missed.
   1. Re-read the textbook on just that subject.
   1. Ask your peers how they would approach this question.
   1. Write out the rationale for the correct response.

• You need to be able to combine more than one concept at a time. Lower-level items require knowledge only. However, application-level exam questions usually involve some sort of scenario. The scenario requires you to apply knowledge using more than one concept, fact, technique, and/or rule.
  • Develop higher-level clinical reasoning abilities while studying, at clinical, or when meeting with peers
    • Facts and knowledge are considered “lower-level” knowledge. Hence, clinical reasoning involves “higher-level knowledge.” Technically, “higher level” knowledge is application, analysis, or evaluation. For simplicity’s sake in this post, however, I’ll talk focus on application-level exam questions.
  • Exam candidates need to do clinical reasoning to perform on-the-job roles and responsibilities. Most often you will use application skills of:
    • Prioritizing
    • Comparing
    • Determining
    • Predicting
    • Adapting
    • Confirming
    • Performing
  • Therefore, expect to see questions such as:
    • Prioritizing-Which patient with COVID-19 should be seen by the nurse first?
    • Comparing- In terms of effectiveness and side effects, how does traditional chemotherapy compare to immunotherapy as a treatment for certain types of cancer?
    • Determining- How can healthcare providers determine the most effective treatment plan for a patient with multiple chronic conditions?
    • Predicting- Given these healthcare data, the nurse can anticipate that…
    • Confirming- In a clinical trial, how can researchers confirm the efficacy and safety of a new medication compared to a placebo or standard treatment?
    • Adapting- With the emergence of new variants of the COVID-19 virus, how can healthcare providers adapt their vaccination and treatment strategies to effectively protect and treat patients?
    • Performing- How can healthcare metrics be used to drive improvements in healthcare delivery and outcomes?
  • Be able to recognize clinical conditions
    • It is important to recognize the typical way a patient with a certain condition presents.
    • First, you’ll need to recognize the typical presentation. Then, you’ll need to know what to do about it.
    • Ways to help with this. When dealing with lab values, focus on what is different from the other abnormal lab values. For example, nearly everyone with an electrolyte imbalance is nauseated, so that isn’t as important to know as someone with a high potassium level can have cardiac dysrhythmias.

3. Cement your learning. Do not spend all of your time reading the textbook. Take practice questions and review your incorrect answers in order to apply the concepts to patient scenarios. Take practice tests as your test day gets closer. Use your performance on these practice tests as an indication of what you most need to study more. Practice tests also help you get used to the structure of the exam as well as the content. Time management under pressure, for example, is an incredibly important skill for nursing school exam success.
4. Study frequently in short sessions. This is a winning preparation strategy for many students and is much more effective than marathon study sessions that occur infrequently. Review what you’ve learned the same day that you learn it.

• Application questions demonstrate the highest level of complexity in-text questions.
  • A student must be able to synthesize multiple sources of information.
  • To answer questions correctly a student must understand instead of just recall.
  • Application questions involve the evaluation of data, complex problem solving, making judgments, and integrating multiple aspects of your coursework.

• Study in groups: Working with others can be helpful when studying for application-level exams. Discussing the concepts and solving problems together can help you deepen your understanding and identify areas where you need more practice.
• Use study aids: There are many study aids available for application-level exams, such as practice exams, study guides, and online resources. Use these resources to supplement your learning and identify areas where you need more practice.
• Review and revise: As you study, make sure to review and revise the material regularly. This will help you consolidate your learning and identify areas where you need more practice. Writing out your study notes (not typing them out) may help you to understand more than other study methods. Drawing your concepts can be helpful as well.
• Stay focused and motivated: Application-level exams can be challenging, so it’s important to stay focused and motivated throughout the study process. Set goals for yourself, take breaks when you need to, and stay positive and persistent.

Overall, studying for application-level exams requires a combination of understanding the concepts, practicing problems, studying in groups, using study aids, reviewing and revising, and staying focused and motivated. With the right approach and effort, you can succeed on application-level exams.

References

Mørk, G., Magne, T. A., Carstensen, T., Stigen, L., Åsli, L. A., Gramstad, A., … & Bonsaksen, T. (2020). Associations between learning environment variables and students’ approaches to studying: a cross-sectional study. BMC Medical Education, 20(1), 1-8.

Mørk, G., Gramstad, A., Åsli, L. A., Stigen, L., Johnson, S. G., Magne, T. A., … & Bonsaksen, T. (2022). Approaches to studying: changes during a three-year undergraduate study program. Scandinavian Journal of Educational Research, 1-13.

Sebesta, A. J., & Bray Speth, E. (2017). How should I study for the exam? Self-regulated learning strategies and achievement in introductory biology. CBE—Life Sciences Education, 16(2), ar30.

Thørrisen, M. M., Mørk, G., Åsli, L. A., Gramstad, A., Stigen, L., Magne, T. A., … & Bonsaksen, T. (2022). Student characteristics associated with dominant approaches to studying: Comparing a national and an international sample. Scandinavian Journal of Occupational Therapy, 29(1), 13-24.