Are You Failing Nursing Exams Even Though You Know Your Stuff?? (how to deal with test anxiety)

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How to Deal with Nursing School Test Anxiety

By Kati Kleber, BSN RN CCRN

Learning how to deal with test anxiety is not fun.  It’s something that many of us experience during nursing school for various reasons… there are many exams, assignments and deadlines we are juggling, very complex information we’re learning at lightening speed, and frequently there are 25-50 question exams over hundreds of pages of material.  This can be a recipe for disaster for people that don’t struggle dealing with test anxiety, let alone for those that do!  Here are four practical ways to help navigate this frustrating experience.

However, I do want to make sure we’re on the same page when I use the term anxiety.  I don’t mean that you get a little worked up before an exam, like you would before a high school sporting event:

  • Fear.  Gripping fear.  
  • Unable to think about anything but this exam.  
  • Heart racing.  
  • Pounding out of your chest.  
  • Your thoughts are only of the worst-case, I’m going to fail nursing school and I can’t do this and I’ll never be a nurse, scenarios.  
  • Chest pain.  
  • Shortness of breath.  
  • Sweating.  
  • Flushed.  
  • Exhaustion
  • Past the point of no-return
  • Unable to calm yourself
  • Unable to reason with yourself

… that kind of anxiety.

Per Dr. Elizabeth Hope at the Center for Anxiety and Traumatic Stress Disorders at Massachusetts General Hospital and an assistant professor of psychiatry at Harvard Medical School, “People with anxiety have a problem dealing with distracting thoughts that have too much power.”  She goes on to state, “They can’t distinguish between a problem-solving thought and a nagging worry that has no benefit.”  (Source)  Anxiety is very real and very challenging to deal with, especially during nursing school when you’re learning so much information so fast and dealing with people’s lives.


Proper preparation is key.  If you know you are adequately prepared, you are able to rest in that reassurance to a certain degree..  This can mean very practical preparedness, like making sure you have everything you need for clinical, washing your scrubs a few days before you need them, or setting out everything you need for class the night before.  

Whenever I had a new clinical site assignment, I would do a dry-run the night before.  I’d drive to the location, walk up the unit, and get the lay of the land so I had a better idea of what to expect in the wee hours of the next morning.  Anything I could do to lessen the fear of the unknown was helpful for me.   

Make sure to also prepare mentally as well.  This means making sure you’ve allowed adequate time not only to get through the reading assignments, but process the information.  Schedule yourself time to study and not in a rushed sort of way, but in a way that enables you to complete the reading and comprehend it.

 At, we created a whole academy of courses to help nursing students comprehend information, not just get through it…  Check it out here.  There is a lot to balance, so make sure you schedule your study times at the beginning of the semester, which may be a challenge, but it will absolutely be worth the time.  You’ll be able to rest in knowing you’ve allocated time to address everything, and therefore be able to focus better on what you’re studying.


Share your struggle with your professors.  Let them know that you’ve had panic attacks, that you struggle with anxiety, but you’re willing to do whatever you can to be successful.  

It is really helpful when you’re either on the verge of an attack, or when you’re acutely experiencing one, that you know someone in the room already knows.  Trying to communicate that while it’s happening is much harder than being able to look someone in the eyes and they just know things just got serious.  Having that reassurance that there’s someone in the room that is aware can bring that anxiety threshold down a bit.


See if your professors will let you review exams afterwards so you can understand what happened.  Was it a lack of knowledge in something specific?  Or were you doubting yourself?

Do you need to get better at trusting yourself with knowledge you know, or are there things you need to put more time into comprehending?  Talk through questions with your professor.  Utilize office hours.  

Turn your relationship with your professor and exams from something scary and anxiety-producing into to something familiar, expected, and an opportunity to really dig into the material and learn.

RELATED ARTICLE: How to Talk to Nursing Professors (even when they don’t want to talk to you)

There are also a lot of different formatted questions in nursing school, which require a different approach.  One of the most frustrating kinds are select all that apply ( or SATA).  We recently wrote a master-post about how to systematically work through those to help students do better on them and take the fear and frustration out.  

However, some professors may not let you review your exams after.  But, if you explain to them your struggle, purpose, and willingness to improve, they may do whatever they can to ensure your success and comprehension.  This also really demonstrates to professors how important this is to you and your dedication to not let anxiety keep you from rocking these exams. It can’t hurt to ask.


I personally struggle with anxiety and spoke with my primary care physician about it.  She highly encouraged me to meditate regularly.  She informed me that it decreases the anxiety threshold.  

I struggle with anxiety, particular related to travel.  I started to meditate before upcoming trips and noted a tremendous difference.  I really encourage you to regularly meditate daily, just try it for a week… 10 minutes in the morning, 10 at night.  See if that decreases your anxiety threshold, particularly during intense testing periods, like midterms and finals.   

Also, make sure you’re getting adequate rest.  Sleep deprivation may make you more anxious, whether or not you realize it.  Check out these really practical and helpful tips on getting good rest from the National Sleep Foundation.

Many people, including nurses, struggle with anxiety.  Test anxiety should not keep you from being a successful and amazing nurse. Prepare both practically and mentally.

RELATED ARTICLE: What I Learned Failing the NCLEX® 3 Times (RN . . . More Than an Abbreviation)

Check out all of courses to see how we can help strengthen your comprehension.  Share your struggle with your support system and your professors.  Review your exams.  Relax at home so you’re at the top of your game when it’s time to sit down and test.  

Go team!

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