Even the most prepared student can start to panic during an exam. It’s what you do next that dictates whether test anxiety is going to take over and run the show, or if you’re going to get past this moment and continue on with the exam.

When you start to feel like the test is getting out of your control, you may experience things like:

  • An increase in heart rate
  • A feeling of anxiety or dread
  • Checking and re-checking the clock
  • Reading the question over and over without comprehending what it’s saying
  • Negative self talk (ex: “I’m going to fail this exam” or “I’m running out of time.”)
  • Inability to process information to decide on the correct answer
  • A sick feeling in your stomach
  • A rush of adrenaline
  • Sweating and even tremors

None of these feel good during an exam, but here’s the deal. The exam is going to keep happening, so if you want to come out the other side without too much damage, you need to find a way to cope and fast!

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So here are some things to do when you start to panic during an exam:

Step 1: Pause

The most important thing you can do in this moment is pause and take some time to regroup. Take at least five deep breaths in and out just to clear your mind of the negative thoughts and to decrease some of the tension in your body. It may help to bring your shoulders down-clench your fists as you inhale, and actively release them as you exhale as a way to encourage overall muscle relaxation. 

Step 2: Reframe

Next take five more breaths to adopt a more positive mindset. Choose a mantra that is true and believable such as “I’ve prepared well and I’m doing my best.” Repeat this mantra as you inhale and exhale five more times. 

Does this take time? Yes, of course it does. But if it can get you out of panic mode, it will save you time overall and get you back on track. The two minutes it takes to pause and take some deep breaths is definitely time well spent in an exam that’s being sabotaged by test anxiety.

Step 3: Resume

Once you feel more calm, continue on with the exam. Use the following strategies to help you arrive at the best answers: 

  • Read the question slowly to ensure you don’t skip over any key words such as “all, none, except, most, least, and priority.” And then read the question again. 
  • Keep an eye out for negative qualifiers such as, “Which option indicates the patient needs further teaching?” This means you are looking for the one statement that is incorrect.
  • If you have to add information into the question or make assumptions, you’re heading down the wrong path. Everything you need to answer the question correctly is there.
  • Think about what you already know about the topic and don’t waste time fretting about what you don’t know. Try to anticipate what the answer might be before you look at the options.

You can also answer questions more easily if you understand what they’re driving at:

  • ABCs – The ABCs refer to airway, breathing and circulation. For example, if your patient has an airway obstruction and a BP of 72/44, what are you going to address first? While both are important, you’re going to clear the airway first! If your patient is breathing 5 times a minute with an SpO2 of 77% and has an arrhythmia…what are you going to address first? The respiratory issues! The only time C comes first is in cardiac arrest, when you immediately start compressions as soon as pulselessness is verified.
  • Maslow’s Hierarchy of Needs – Many exam questions can be answered using Maslow which dictates the more basic needs must be met before higher needs can be attained. At the lower levels are the physiologic needs and safety. Things like belonging, self esteem and self actualization are at higher levels. In other words, physiologic needs are going to take priority over anything else!
  • Safety – Some questions will be focused on safety, so when faced with a question like this ask yourself, “Would not doing X cause the patient harm?” This can often lead you to the correct answer.  Note that many times the correct answer will involve the nurse staying with the patient!
  • The Nursing Process – Though schools are moving toward a more robust framework such as the Tanner Model, the nursing process still has a place as the foundation of nursing practice. Many times you can answer a test question based off where it lands in the nursing process (and hint…a lot of times the answer is to obtain more data…or assess!).

So next time you’re in an exam and you start to feel the anxiety mounting up, I want you to pause, regroup and refocus. You’ve got this!


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