Pass Your OIIQ Exam with these 10 PRO Tips!

OIIQ Exam

This is the script of the video, so that you won't missed anything.

How to Use These Tips?

These strategies are not exclusive to the OIIQ, they can be applied to any nursing exam, including:

• Nursing school exams

• OIIAQ exam

• Next Gen Nclex-RN and Next Gen Nclex-LPN

  
  

This guide includes practice scenarios. You can pause the video to read at your own pace, and timestamps are available for easy topic selection.

Without further ado, let’s begin! 

Tip #1. The question!

Start by reading the question before analyzing the full scenario. Why? It saves time because you’ll already know what information the scenario is looking for. Many OIIQ questions can be answered without reading the scenario at all! Try answering this question without reading the scenario. The correct answer is B. Repeated episodes of hyperglycemia over the past 3 to 4 months. A1c reflects average blood glucose levels over the past 3 to 4 months.

As you can see, the question itself contained all the information needed—no scenario required!

Now, let’s review the full scenario before moving on to the next question.

Read the question first.

Yes, you got it again. The correct answer is D.  Thiamine is prescribed for patients with a history of alcoholism to prevent and manage Wernicke’s encephalopathy, a neurological disorder caused by thiamine deficiency.

Tip number 2

Tip #2. The Main Scenario!

Where can you find the main scenario?

Is it at the start? in the middle? or at the end?

In most cases, the main scenario is located at the end.

There are three key elements to determine the main scenario:

Number 1. The Current time. for example. "At 15:00," "In the morning," or "30 minutes later."

Number 2. The Current location. such as, "In the hallway," "Inside the patient’s room," or "During art therapy."

and number 3. The Current patient condition. like, "Complaining of pain," "Vital signs are…," "Signs and symptoms include…," or "Laboratory results indicate…"

Here’s an Example question.

Even though the scenario mentions discharge at 18:00 and another time at 14:30, the most relevant time is 15:30, when the patient reports,

"My right shoulder hurts, pain rated at 3/10."

This is the main scenario because it highlights the patient's current condition.

The correct answer for this question would be A. Lie on your left side.

Shoulder pain after a laparoscopic cholecystectomy is often due to residual carbon dioxide gas used to inflate the abdomen. Lying on the left side helps move the gas, allowing it to be absorbed more easily, thereby reducing discomfort.

Now, we have another Example here.

Even in a long scenario, if you identify the main scenario, starting at “Fifteen minutes later…” near the end, that section will often provide enough context to determine the correct response.

So, when responding to Ms. Gascon, we would answer "No", because the snack she chose would slow down carbohydrate absorption.

Tip #3. The PRN!

Before diving into PRN orders, let’s first clarify routine doctor’s orders to fully grasp this concept.

What is a Routine Order?

A routine order is a prescription followed until another order cancels it.

For example: "Lisinopril 10 mg PO daily."

Medications should be administered on time whenever possible. However, in a busy clinical setting where multiple patients require multiple medications at the same time, strict adherence to exact timing can be challenging.

To accommodate this, medications can be given within a 30-minute window before or after the scheduled time.

Some medications must be given at their precise time due to their pharmacokinetics.

For example: Antibiotics must be administered exactly as prescribed to maintain therapeutic levels.

If the scenario specifies a time that aligns with routine orders, such as 8:00 AM, then medications scheduled between 7:30- 8:30 should be administered.

Example:

If a patient’s Medication Administration Record lists the following routine medications at 8:00 AM, they should be given unless contraindicated. In this case, administer: Humulin, Flonase, and Flunisolide.

However, if the patient’s condition justifies holding a medication, it should not be administered.

Example:

If the patient is experiencing nosebleeds, you should hold Flonase, as it could worsen bleeding.

Now, Let’s Talk About PRN Orders!

PRN orders are one of the most critical components of the OIIQ exam. You are tested on which medication should be administered based on patient symptoms, rather than simply following a scheduled routine.

Unlike routine orders, PRN medications are given as needed, regardless of the time in the scenario.

Example:

If a patient presents with pain, and the MAR includes:

Acetaminophen 500 mg PO every 4-6 hours as needed for PAIN, then this should be administered.

Similarly:

If a patient has pruritus (itching) → administer Hydrocortisone cream 1% (if listed in the MAR).

Key takeaway: PRN orders are given based on the patient's condition at the time, not just based on a scheduled administration.

Is your  patient nauseous? Administer Dimenhydrinate

Is your patient anxious? Administer Vistaril

Is your patient constipated? Administer milk of magnesia

Is your patient complaining of pain? Administer Tylenol

Let’s analyze a real OIIQ exam scenario:

Since his associate’s call, Mr. Tremblay is diaphoretic and has non-radiating pain rated at 7/10. He is experiencing retrosternal pain.

Which medication will you administer?

The appropriate answer is letter C. Nitroglycerin for retrosternal pain.

This is the correct choice because retrosternal pain and diaphoresis are classic signs of angina or a cardiac event, requiring nitroglycerin to relieve chest pain.

Here’s another example.

At 13:15 Mrs. Mcdonald has unbearable pain.

Which TWO medications will you administer?

Mrs. McDonald’s pain is unbearable despite the regular administration of hydromorphone. She can be given a PRN analgesic subcutaneously and the acetaminophen is indicated for use as a co-analgesic with opioid analgesics.

Now, let’s evaluate incorrect options:

Answer B: Hydromorphone PO – This cannot be administered at 13:15, as timing may not align with the prescription. It was last given at 12:00, this medication should be administered every 3 hours.

Answer D: Anxiety medication – The patient does not show signs of psychological distress, so this is not appropriate.

Final Takeaway

• Routine orders are administered at scheduled times unless contraindicated.

• PRN orders are based on the patient’s current symptoms and should be given as needed, regardless of time.

Before we go to Tip number four. I have an advice for you when you’re looking at the Medication administration Record. The most important day to check is Today, not yesterday, and not tomorrow.

Here another MAR example.

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Tip #4: The protocols!

A protocol—also known as a standing order or order set—is one of your best tools during the exam.

Whenever a scenario includes a protocol and an intervention is required, the protocol is usually the correct answer.

Recognizing Protocols in a Scenario

Protocols often follow this pattern:

✅ "IF + patient’s condition, THEN intervention"

Examples:

• If chest pain, then intervention

• If shortness of breath, then intervention

• If level of sedation is 3 or 4, then intervention

How to Choose the Right Intervention?

If multiple protocol interventions are listed, choose the one that has NOT been done yet.

Here’s an Example Scenario

Protocol for Retrosternal Pain:

·      ECG STAT

·      O₂ at 3L/min via nasal prongs

·      Nitroglycerin sublingual spray q5 min x3 PRN

Question 1: What should the nurse do first?Since the patient is experiencing retrosternal pain, the correct answer is: Letter C: Perform an ECG and administer O₂ at 3L/min via nasal prongs.

Question 2: What other priority intervention must the nurse perform?Since one intervention is still left in the protocol (Nitroglycerin), the correct answer is:Letter A: Administer Nitroglycerin sublingual spray.

When a STAT Order Overrides the Protocol

A STAT order is a one-time, immediate order given due to the urgency of the situation.✔ If a STAT order is present, it takes PRIORITY over the protocol.

Example:If a scenario includes a STAT order for IV lactated Ringer’s solution, and the patient is showing signs of shock, the correct answer is:✅ Administer IV lactated Ringer’s solution STAT.💡 Do NOT look for other interventions—STAT orders always come first!

Key Takeaways

1️⃣ Follow the protocol if an intervention is required.2️⃣ If multiple protocol orders exist, choose the one that has NOT been done yet.3️⃣ If a STAT order is present, it is ALWAYS the priority.

Tip # 5: The scale!

Not this scale.

When a scale is provided in a scenario, always follow the specific instructions written on that scale.

Examples of Common Scales in Nursing:

Bromage ScaleInsulin Sliding ScaleHeparin Infusion Scale...and many more!

The key to answering these questions correctly is to check the patient’s current condition, match it to the scale, and follow the corresponding intervention precisely.

Example 1: Bromage Scale

• Current time: 08:30

• Patient's current condition: Bromage score of 3

• Protocol for Bromage score of 3:

  ✔ Stop infusion

  ✔ Contact pain service, physician, or anesthesiologist

Question: What should the nurse do?Correct answer: Stop the epidural anesthesia first, then notify the anesthesiologist.

Example 2: Insulin Sliding Scale

• Current time: 20:00 (8:00 PM)

• Patient's condition: Capillary blood glucose (CBG) result = 10 mmol/L

• Medical order:

  
  

  ✔ Regular insulin sub-Q according to scale QID

  ✔ 1/2 dose at bedtime

• Insulin sliding scale:

  ✔ 10 mmol/L = 4 units of regular insulin

  ✔ Since it’s bedtime (8:00 PM), only half the dose should be given

Question: What should the nurse do?Correct answer: Letter A. Administer 2 units of regular insulin.

Tip #6: The request!

Requests from patients, family members, or colleagues (orderlies, LPNs, RNs) are often incorrect in exam scenarios.

How to Approach Requests in the Exam:

1️⃣ Your default response is usually NO—but you must justify why.2️⃣ Assess the request:

• Does it pose harm to the patient or others?

• Is it unethical?

• Does the requester need education or clarification?

If the request meets any of these criteria, it is incorrect and should be refused.

Example 1: Access to Medical Records

Question: A patient requests access to their medical records. What should the nurse do?

✅ Step 1: Identify incorrect answers.

• Any response that agrees with the request is likely wrong.

• Eliminate options A and B (which say YES).

✅ Step 2: Choose the appropriate NO response.

• Correct answer: Letter D.

  “No, the person in charge of the archives department is responsible for determining whether or not a client may access their medical record.”

Example 2: Side Rails Request

Scenario: A patient’s daughter requests that all side rails be raised.

✅ Step 1: Recognize the issue.

• Raising all side rails is considered a restraint, which can increase the risk of falls and injury.

• This is a teaching opportunity rather than just refusing the request.

✅ Step 2: Eliminate YES answers.

• Remove answers that agree to raise all side rails.

✅ Step 3: Choose the correct NO response.

• Correct answer: Letter D.

  
  

  “No, raising all side rails is considered a restraint and increases the risk and severity of falls or injury.”

Key Takeaways:

🔹 Requests are often incorrect.🔹 Identify if the request is unsafe, unethical, or requires teaching.🔹 Remove YES answers first, then choose the correct NO response.🔹 Justify your answer with patient safety and best practices.

TIP #7: Medication Toxicity

Recognizing medication toxicities is essential, such as lithium, digoxin, and phenytoin (Dilantin). However, you do not need to memorize toxic levels. Instead, focus on identifying the signs and symptoms of toxicity because normal values will always be provided in the exam.

Trick to Watch For:

Lab results are often within the normal range but at the highest possible values. For example:

• Lithium normal range: 0.6–1.2 mEq/L

• An exam question might report 1.2 mEq/L—not above this—so you must rely on symptoms to detect toxicity.

Example Question:

Mrs. Emily’s digoxin level is 2.6 mmol/L (which appears within the normal range), but she is tired, dizzy, has weak muscles, and altered colour perception.

What should you do?✅ Correct Answer: D. No, because she is showing signs of digoxin toxicity.

TIP #8: The opposites!

When two answer choices are opposites, one of them is usually correct.Examples of opposing pairs:

• Left vs. Right

• Yes vs. No

• Cold vs. Hot

• Supine vs. Prone

• Increase vs. Decrease

Example Question:

Mrs. Latour has heart failure. At 10:00 AM, you hear bilateral crackles, she is short of breath while speaking, and she looks pale—signs of pulmonary edema. You decide to place her in High Fowler’s position.

Why?Looking at the answer choices, two options contradict each other:✅ Decrease vs. Increase✅ Preload vs. Afterload

The correct answer is C:"Positioning the patient in High Fowler’s with legs dependent reduces preload by decreasing venous return to the right atrium."

TIP #9: The Secret of "S"

When selecting an answer, always follow the instructions carefully regarding the number of answers required.

• If the question states “Choose one answer,” select only one answer.

• If it states “Choose two answers,” select exactly two.

• If the question asks you to use clinical judgment to determine the number of answers, expect two or more correct choices.

Trick to Watch For:

Look for the secret "S" hidden inside parentheses ( ) in the question. This often indicates that you need to select multiple answers.

By identifying this pattern, you can make more accurate answer choices!

Let’s try this question!

At 21:30 Mr. Dery with shingles has burning pain at 7/10 with intense itching.

Question: Which medication open and close parenthesis S will you administer?

Time: 21:30 – administer Acetaminophen and pregabalin

Patient complaints: 1. Burning pain 7/10 – administer hydromorphone

2. Intense itching – administer Diphenhydramine

TIP #10: THE SUSPECT!

Not a criminal suspect, but rather the complication of a disease. The question will often ask: “What do you suspect is happening to the patient?”

Key Strategy:

Familiarize yourself with common complications of diseases.

Examples:

A postoperative patient is at risk for hemorrhage, so you must recognize signs and symptoms of hypovolemic shock.

A patient receiving opioids is at risk for respiratory depression, so monitoring their breathing is essential.

Scenario #1: Deep Vein Thrombosis!

A patient with DVT is at risk for the thrombus breaking off and traveling to the lungs, potentially causing a pulmonary embolism (PE).

Case Example:

Marie Dupont presents with:

Sudden onset of chest pain

Shortness of breath

Anxiety

Low blood pressure (88/52 mm Hg)

Tachycardia

These symptoms suggest a possible pulmonary embolism.

Scenario #2: Pulmonary Edema!

At 22:00, a patient is experiencing severe shortness of breath (orthopnea) and cannot lie down in bed.

Background Information:

History of heart failure

Weight gain of 3 kg in the past week

Received two units of blood (one in the morning, one in the afternoon)

Given these factors, we suspect fluid retention or overload, leading to pulmonary edema.

Thank you so much for making it to the end of the video! 🎉 As a bonus, here’s an extra tip just for you.

Tip #11 – The mindset!

Passing the OIIQ exam is not just about knowing the material—it’s about having the right mindset, discipline, and confidence. Many students fail not because they lack knowledge, but because they allow stress, fear, and doubt to take over.

1. Shift from "I Hope" to "I Will"

• Stop saying, "I hope I pass."

• Start saying, "I will pass because I am preparing the right way."

• Your thoughts influence your actions—believe in yourself and back it up with effort.

2. Study with a Purpose, Not Just for Hours

• Quality over quantity – Don’t just read for hours; focus on understanding concepts and applying knowledge to scenarios.

• Simulate exam conditions – Take timed practice tests to train your brain to work under pressure.

3. Reframe Challenges as Learning Opportunities

• Instead of saying, "I keep failing practice questions, I’m not ready," say:

  • "Every mistake I make now is a lesson that prevents me from making it on the real exam."

• Analyze why you got a question wrong and learn from it.

4. Manage Exam Anxiety with Preparation & Routine

• Anxiety comes from uncertainty—reduce it by having a solid plan.

• Night before the exam:

  ✅ Review key concepts lightly

  ✅ Prepare your documents & materials

  ✅ Sleep early

• Morning of the exam:

  ✅ Eat well, hydrate

  ✅ Practice deep breathing—calm mind = better recall

  ✅ Remind yourself: "I am ready, I can do this."

5. Never Underestimate the Power of Self-Care

• A burned-out brain cannot retain information—balance study time with rest.

• Exercise, eat well, and take breaks to keep your mind sharp.

Final Words: Act, Believe, and Achieve!

The OIIQ exam is not a test of intelligence—it is a test of preparedness and confidence. Go in with the mindset that you deserve to pass because you have put in the work.

✅ Believe in yourself.✅ Prepare with focus.✅ Stay calm and trust your training.

🌟 You are capable, you are ready, and you will succeed! 🌟