Grading Each Answer Option

For some questions, you will identify the correct answer by simply reading the stem carefully and scanning the answer options. Other questions will be more difficult, and you will need to do more than simply scan the answer options–you will also need to closely examine the options to identify which one is best. To help you do this efficiently, we recommend a three tiered approach in which you mentally label an answer as either: 

correct (plus sign), 

maybe correct/maybe incorrect (question mark), or 

incorrect (minus sign). 

The grade you assign to an answer option is usually primarily based on its accuracy (for example, is it consistent with your knowledge, does it reflect a good decision?) and its relevance to the practice situation in the stem (is the answer well supported by the information in the stem?).

Here is an example of how to grade answer options:

The therapist is referred a client who is an adult female. The client recently quit her job of 20 years because “it just wasn’t satisfying anymore.” Currently she is collecting unemployment but is still covered by her health insurance from work. She has been divorced for five years but does not date and states that she is “not that interested” in finding someone new. She reports feeling depressed and lonely and recent weight loss. The therapist also notices that she looks pale. Which of the following actions should the therapist initially take in this situation?

a. Provide relaxation training.

b. Assess suicide potential.

c. Assess social support network.

d. Explore history of depression.

The stem describes a client who is currently depressed and may be in crisis, and then asks for the therapist’s initial action. Neither “a” nor “d” is an appropriate initial action to take with a depressed client in crisis, so we’ll give both options a minus grade. We’ve eliminated two answer options. Answer “b” is a very good initial action to take in this situation–we’ll give it a plus grade. Answer “c” is a good action to take in this situation, and it may deserve a plus grade on its own–if we compare “c” directly to “b”, however, it becomes clear that “b” is the better option of the two.

Notice how mentally grading answer options is an effective way of organizing your approach to an exam question: It gives you a shorthand way of tracking your decision-making about the answer options. In this situation, we were able to quickly rule out two answers and to easily compare the two that remained. Try this strategy and let me know what you think!