Help! Standardized Tests Increase My Students’ Stress

Say the words “standardized test,” particularly when the results of the test contributes to a grade, and students become stressed. It is painful for faculty to watch this stress build and we all want strategies to mediate this negative response. What are some strategies that faculty might implement to help students cope?

Some suggest that the best approach is to eliminate standardized tests during nursing school and depend only on faculty-made tests to determine student progress. However, this strategy is very much like never letting your children ride bikes because they might get hurt. There will likely come a time, as children grow, when they will gain a great deal of physical and psychosocial benefits from riding that bike. Similarly, despite the stress associated with taking standardized tests, they help students to prepare for the NCLEX® examination, which they MUST take. In addition, when these tests are required throughout the curriculum and at the end of the course of study, students receive a great deal of information about individual and aggregate performance. These results can be used as direction for student remediation AND for curriculum revision. So the question becomes, “How can faculty help students manage stress associated with taking standardized tests?” The following are tips that may help.

  1. Standardized tests should not be used as the single evaluation method to determine students’ ability to sit for the NCLEX exam. However, to ensure that students take the test seriously, their results should be a significant factor in the course grade for selected courses. Faculty should check the requirements (or recommendations) of their state Board of Nursing on this issue.
  2. Ongoing preparation for the NCLEX examination throughout the course of study is essential. Examples of this type of preparation may include:
    • Discuss with students, on an ongoing basis, the reasons for requiring standardized tests and give them specific instructions about their use, including the structure and organization, how they should prepare, and the way the results will be used. Most students are more accepting of stressful situations if they know in advance what will happen.
    • Write items in faculty-made tests using the same format and level of difficulty (emphasizing Bloom’s taxonomy characteristics of application and analysis) as the NCLEX examination. Refer to the Detailed NCLEX-Test Plan for Educators, for more information.
    • Choose teaching-learning activities that reflect the NCLEX-RN Client Need categories and Integrated Processes, rather than emphasizing disease processes. Again, the Detailed NCLEX Test Plan (Educator version), particularly the related activity statements, can be very helpful.
    • Present one or two sample NCLEX-style test items at the end of class to emphasize important points. Students can use “clickers” or their phones, or simply raise their hands, to choose the correct answer to the question posed. The instructor can then help the students with the rationale for the correct answer.
  3. Offer content-specific standardized tests across the curriculum. This not only gives students an opportunity to practice test-taking skills in this format, but it also demonstrates how helpful the individual results can be in directing them to further study.
  4. Provide students with stress reduction strategies, including the following “Stress Busters” from the Kansas State University Counseling Center. (
    • Get a good night’s sleep before the test.
    • Take a walk before coming to the test.
    • Come early to the test to get a place that feels comfortable. (Avoid sitting by people who are observably anxious.)
    • When you get the test, read the directions TWICE.
    • Close your eyes and breathe deeply for two to five minutes, concentrating on the air going in and out.
    • Tense and relax different muscle groups. As the muscle groups relax, you will become aware of the relaxation of the muscles, and thus are more likely to relax.
    • Use positive self-talk, particularly to counteract negative talk. Instead of “I am going to fail this test,” think “I am prepared for the test.”
    • Think about post-exam rewards for a minute as a way to motivate yourself.
    • Don’t rush through the test, but work at a comfortable pace. Don’t worry about how far along your classmates are on the test.
  5. Develop and implement a robust remediation program that requires students to be accountable for the remediation. This ensures that students will learn appropriate material as they move through the program. In addition, it presents effective study skills that can be used in later situations.
  6. Refer students who seem to have test anxiety that cannot be addressed with these tips to institutional resources.