Learning Objective #1: evaluate the relevance of strategies commonly taught to prepare students for licensing examinations such as question analysis and test-taking tips.

Learning Objective #2: acquire insight into students’ emic perspective when responding to application-level test questions used in licensing examinations.

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Nursing education has limited evidence to support many current practices. Since graduates of nursing programs in the United States cannot practice without passing the national licensing examination (NCLEX), educators typically attempt to prepare students in some way for this examination. A common strategy is to teach students how to analyze NCLEX-style questions and how to use test-taking tips. There is currently little evidence to support the efficacy of these approaches. The literature currently provides no information on students' thoughts when answering NCLEX-style questions. The purpose of this descriptive qualitative study was to discover whether beginning nursing students at the foundations level used the test-taking strategies and analysis techniques they had been taught when responding to typical NCLEX-style questions. The aim was to uncover students' targeted thinking when selecting answers. Students were shown how to analyze NCLEX-style questions and given several test-taking tips as a part of the foundations nursing course. At the end of the semester for 5 different semesters, a total of 300 students were asked to respond to one of 18 different test questions by writing out the reason for selecting the correct option and the reasons for rejecting the other three options. Initial content analysis of the written responses indicates that individual students exhibit a significant lack of consistency in their thinking when responding to different questions. Some of the common errors in test-taking, such as answering based on personal experience, or adding information to the question, seem to be related to a basic lack of knowledge. Knowledge errors fell into several categories including incomplete information, misapplication of correct information, and use of inappropriate information. Further, students often answer a question different from the one being asked. There was little evidence that students used the strategies they had been taught.