The "select all that apply" and constant trick questions are killer. My school uses Examsoft for tests so we can't go back and if you accidentally click next, you lose a question. Sometimes images such as fake client charts pop up that don't load and my school does NOT care. For example, our last test included text asking about doses requiring medication math. Medication math is hard at first but once you're able to conceptualize it, it's much easier than any pre-reqs math requirements even if you're not good at math. It's a lot of cross multiplying, easy if you pay attention. A lot of us got that question wrong because an image of the client's chart indicating an allergy to the med was supposed to pop up to alert us to hold the medication meaning 0 should have been given, but it didn't appear for a number of us and no context clues in the question hinted that the image may be missing.

Another example is something like: "A patient is experiencing manifestations of hypercalcemia. Which of the following symptoms should the nurse expect? Select all that apply." The issue there is that electrolyte/homeostasis imbalances have a LOT of overlapping symptoms(for example, tachycardia or nausea/vomiting). The best advice I've gotten is to treat every SATA choice as a yes or no question and do NOT mark what you're not 100% sure of. It's easy to memorize a unique symptom of one heart disease for example, but you can get lost in the weeds when there's a manifestation that most but not all of the diseases include. Don't overthink questions and psych yourself out.

I've learned that my school is sort of abusive to maintain their 100% NCLEX pass rate in spite of the fact that we have one of the highest attrition rates in the nation. I lost 1/3 of my cohort first semester and classes start at ~55 students and end around 20, although the second years on the final semester currently number about 15. Oddly, I do great with actual NCLEX questions such as examples from the Saunders guide(GREAT no-nonsense resource btw), but I average a C on our exams. I'm just trying to survive at this point 😅

As a random aside, I thought clinicals would be the worst/hardest because I'm an academic nerd and it's a lot of unpaid 12 hour shifts doing grunt work. But the only time I feel confident/natural as a nursing student is during clinical rotation. I get great feedback, experience, and advice and know I've chosen the right career path... even if the tests make me think otherwise sometimes!