Do you find yourself getting anxious when it's time to take a test? The key to staying on top of anxiety for most successful students is using a combination of techniques to prepare for tests. Here are some tips and tricks you can use to fight anxiety.

• Study well. Studying well is the best preparation for a test--and the best cure for test anxiety. Studying can give you a sense of accomplishment that boosts your self-confidence. By knowing the material backward and forward, you won't feel as nervous going into the test.
  
• Relax your mind. Relaxation, along with other stress-reduction techniques, can help lessen test anxiety. When your body is relaxed, your mind is free to absorb new information. Try using breathing exercises or meditation to clear your mind.
  
• Think positively. Test anxiety can be the result of low self-esteem. Focus on being positive about tests. Say to yourself, "I've studied hard and I know this material. I can do this!" Being prepared and having a positive attitude often lead to success.
  
• Give yourself a break. If you start to feel anxious during a test, consider doing something to break the tension, such as putting down your pencil, closing your eyes, and taking a few slow deep breaths. If your shoulders are hunched, make a conscious effort to lower them and relax. If the instructor allows, you might even get up and sharpen your pencil or ask a question. Sometimes, you feel anxiety because you're physically tired and need a break.
  
• Get your ZZZs--just not during the test! Rest and relaxation are great fatigue-fighters. You can do more when you feel rested and relaxed than when you're tired. Get enough sleep (at least 6 to 8 hours at a time), change activities from time to time, exercise on a regular basis, and relax by allowing yourself breaks for TV, music, friends, or light reading.
  
• Sit up straight. Your posture matters when you're studying or taking a test. If you're sitting in an uncomfortable position, it stresses your muscles. This stress is communicated to your brain, which in turn creates anxiety. Slouching can hurt your back and make you feel tired. Sit up straight and allow your concentration to return.
  
• Eat well. Good nutrition keeps you healthy. It also can improve your study habits and test-taking skills. Class time, work time, and study time often conflict with meal times. To counter this, avoid skipping meals and eat nutritious snacks between sessions.
  
• If you get sick. Even the healthiest person can get sick. When you're ill, you can't perform well on a test. So, if you feel very ill as a test approaches, contact the instructor. This shows you care about your performance and about missing the test. You may be able to work out an arrangement with the instructor, and this will help you avoid feeling anxiety about postponing the test. Be sure to follow all your doctor's instructions so you can get well as soon as possible. Avoid using sick time as study time, and get the rest you need.
  
• Stay on schedule. When a test approaches, keep things as normal as possible. If you normally take a walk before dinner, keep up with your routine instead of skipping your walk to study. If you usually sleep 8 hours a night, avoid the urge to cram until 2 a.m. Breaking good habits will only contribute to your mental and physical stress.
  

Source: Student Success for Health Professionals Made Incredibly Easy! by Nancy Olrech, Lippincott Williams & Wilkins, 2008.

Among the new drugs recently approved by the Food and Drug Administration (FDA):

• Uloric (febuxostat), a xanthine oxidase inhibitor, has been approved for the chronic management of hyperuricemia in patients with gout.
  
• ATryn (antithrombin [recombinant]), a recombinant form of human antithrombin, has been approved for the prevention of perioperative and peripartum thromboembolic events in hereditary antithrombin-deficient patients.
  
• Gelnique (oxybutynin chloride), a transdermal antispasmodic gel that's applied to the skin once daily, has been approved for the treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and frequency.
  

Source: Food and Drug Administration.

When you're caring for a Spanish-speaking patient, sometimes it isn't necessary to translate an entire sentence. Instead, you may be able to use one keyword or phrase to convey information to your patient.

Source: Medical Spanish Made Incredibly Easy!, 3rd edition, Lippincott Williams & Wilkins, 2008.

Worried about passing the NCLEX? The more practice questions you do, the more confident you'll feel. Try these, then review the answers and rationales that follow. Experts recommend taking many practice questions before the NCLEX, so take advantage of review courses, books, and other products to help you succeed and pass the NCLEX. ANSWERS BELOW.

1.	To maintain airway patency during a stroke in evolution, which nursing intervention is appropriate?
	1.	Thicken all dietary liquids.
	2.	Restrict dietary and parenteral fluids.
	3.	Place the client in the supine position.
	4.	Have tracheal suction available at all times.
2.	Primary prevention of osteoporosis includes which measure?
	1.	Place items within reach of the client.
	2.	Install bars in the bathroom to prevent falls.
	3.	Maintain the optimal calcium intake.
	4.	Use a professional alert system in the home in case a fall occurs when the client is alone.
3.	A client is admitted with right lower quadrant pain, anorexia, nausea, low-grade fever, and an elevated white blood cell count. Which complication is most likely the cause?
	1.	A fecalith
	2.	Bowel kinking
	3.	Internal bowel occlusion
	4.	Abdominal wall swelling
4.	Which nursing intervention should be taken for a client who complains of nausea and vomitus 1 hour after taking his morning glyburide (DiaBeta)?
	1.	Give glyburide again.
	2.	Give subcutaneous insulin and monitor blood glucose.
	3.	Monitor blood glucose closely and look for signs of hypoglycemia.
	4.	Monitor blood glucose closely and assess for symptoms of hyperglycemia.
5.	Which comfort measure can be recommended to a client with genital herpes?
	1.	Wear loose cotton underwear.
	2.	Apply a water-based lubricant to the lesions.
	3.	Rub rather than scratch in response to an itch.
	4.	Pour hydrogen peroxide and water over the lesions.

• Nursing2009 Symposium
  May 6-9, 2009, at Disney's Coronado Springs Resort, Orlando, Fla.
• National Teaching Institute & Critical Care Exposition
  May 16-21, 2009, at the Ernest M. Morial Convention Center, New Orleans, La.

Don't miss these substantive, peer-reviewed features from the March issue of Nursing2009. They'll help you learn about evidence-based practice.

• Focusing on the surgical patient with cardiac problems
  By Kate J. Morse, RN, ACNP-BC, CCRN
  Is your patient with heart problems scheduled for noncardiac surgery? Protect him by following this advice based on the latest evidence-based guidelines.
  
• Recognizing and responding to acute liver failure
  By Mary G. McKinley, RN, CCRN, MSN
  Act fast to assess this potentially devastating disorder, identify and manage the underlying cause, and support your patient throughout treatment.
  

1. 4 Because of a potential loss of the gag reflex and potential altered level of consciousness, the client should be kept in Fowler's or a semiprone position with tracheal suction available at all times. Thickening dietary liquids isn't done until the gag reflex returns or the stroke has evolved and the deficit can be assessed. Unless heart failure is present, restricting fluids isn't indicated.
2. 3 Primary prevention of osteoporosis includes maintaining optimal calcium intake. Placing items within reach of the client, using a professional alert system in the home, and installing bars in bathrooms are all secondary and tertiary prevention methods to prevent falls.
3. 1 The client is experiencing appendicitis. A fecalith is a fecal calculus, or stone, that occludes the lumen of the appendix and is the most common cause of appendicitis. Bowel wall swelling, kinking of the appendix, and external occlusion, not internal occlusion, of the bowel by adhesions can also be causes of appendicitis.
4. 3 When a client who has taken an oral antidiabetic agent vomits, the nurse should monitor glucose and assess him frequently for signs of hypoglycemia. Most of the medication has probably been absorbed. Therefore, repeating the dose would further lower glucose levels later in the day. Giving insulin will also lower glucose levels, causing hypoglycemia. The client wouldn't have hyperglycemia if the glybluride was absorbed.
5. 1 Wearing loose cotton underwear promotes drying and helps avoid irritation of the lesions. The use of lubricants is contraindicated because they can prolong healing time and increase the risk of secondary infection. Lesions shouldn't be rubbed or scratched because of the risk of tissue damage and additional infection. Cool, wet compresses can be used to soothe the itch. The use of hydrogen peroxide and water on lesions isn't recommended.

Source: NCLEX-RN Questions & Answers Made Incredibly Easy!, 4th edition, Lippincott Williams & Wilkins, 2007.

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