NCLEX Select All That Apply Questions: Strategy and Examples
5 min read · Updated
Select-all-that-apply (SATA) items list five or more options, and any number from one to all of them can be correct. They feel hard because there is no single answer to spot. The way through is to stop comparing options and judge each one on its own.
A method that works
- Read the stem and decide what it is really asking: findings to report, actions to take, teaching to include.
- Cover the options and think of what you would expect before reading them.
- Read each option as a true-or-false statement against the stem. Mark it true only if it is correct for this client in this situation.
- Do not hunt for a set number of answers. Two correct options is as likely as four.
How +/- scoring changes your approach
With +/- scoring, each correct choice earns a point and each incorrect choice costs one, never going below zero for the item. Choosing an option you are unsure of can cancel a point you have already earned, so select only options you can justify.
Worked example
A client is prescribed furosemide. Which findings should the nurse report? Select all that apply.
Report: serum potassium 3.1 mEq/L (low potassium can cause dysrhythmias); dizziness on standing with a drop in blood pressure (volume depletion); ringing in the ears (ototoxicity). Expected, not reportable: increased urine output (the intended effect); a weight loss of 1 kg after a day of diuresis in a client with edema.
A client with heart failure takes furosemide daily. Which serum potassium result should the nurse report before giving the next dose?
- A4.2 mEq/L
- B3.1 mEq/L
- C4.8 mEq/L
- D3.8 mEq/L
Explanation
The normal range is about 3.5 to 5.0 mEq/L. Furosemide wastes potassium, and 3.1 mEq/L is low enough to raise the risk of dysrhythmias, so the nurse holds the dose and reports it. The other values are within range.
Train on the real format
Every full-length exam includes about 24 select-all items scored with the same +/- rule, so you can see exactly where partial credit is won and lost.