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Secrets to Getting the Right Answer on Application-Level Questions

Woman with a pointed finger with the secret of getting the right answer on application-level questions.

I’ve urged, nagged, begged, pleaded and cajoled you to believe that straight recall items are highly unlikely to be on the IBLCE™ exam. Rather, most of the test items will be at the application level. But today, let me give you some little secrets to getting the right answer on application-level questions.

Remember the aim of the exam

Keep in mind that IBLCE is testing you on what they consider to be your main responsibilities. IBLCE words these responsibilities a little differently, but to me, it boils down to

  • assessment
  • planning
  • implementation 
  • evaluation

And those responsibilities are at the interpersonal and system level. (Say oh, Marie, you make it sound so simple! It’s not.)

As you face an item, ask yourself, “what is my responsibility here?”

Exam construction

The exam usually gives you an item with a stem, and four options. (Sometimes three, sometimes five.) To understand this better, read my post on the anatomy of the exam item.

Only one option is the key (correct answer). All of the other options are DISTRACTORS.

Remember, there’s a reason why exam-writers call those wrong options “distractors.” It’s because they distract you from choosing the right answer!

Not getting sucked into these very alluring distractors is a major part of getting the right answer on application-level questions.

Understanding the “levels”

By definition, an application-level question tests your ability to use more than one concept. Here are some common ways — not the only ways — in which exam-writers can create application-level questions:

  • There’s a particular clinical concept, but clinical management plays out differently at different times along the 2-year continuum.
  • A situation is managed in one way most times, but there’s some odd factor that makes the management different in this situation.
  • Examples-plus. You know that “protein” is needed in a situation, but all four of the options are proteins, and only one protein is correct in this situation.
  • Interpreting cause-and-effect. 
  • Recognizing how some general clinical conditions (e.g., diabetes) are predictive of some lactation-related conditions.

Qualifier in the stem

Basically, qualifiers are words like first, last, most, least, and so forth. From my recollection of taking IBLCE exams, I’d estimate that roughly 25-30% (or maybe more?) of the stems contain a qualifier. Earlier, I’ve given much discussion to “first” in the stem.

However, before you can deal with these, you must be on the lookout for the qualifiers.

In my Practice Exams, I write the stem so that the qualifier visually stands out, for example:

“Which of these techniques is MOST effective for the baby with…”

But on the real exam, I have not seen qualifiers highlighted in any way. Therefore, train yourself to look out for them. In many or most cases, the qualifier makes the difference between the one right option, and the distractors.

Don’t blow by this. This is huge!

“Rules” for picking the right option

No one ever taught me this; I’ve figured it out the hard way. In my estimation, this might be the best-kept secret for getting the right answer on application-level questions.

  • GOALS: Don’t aim for some outcome before you know the mother’s goal.
  • ASSESSMENT: Don’t bail into “doing” until you have assessed.
  • PLANNING: This frequently requires interpreting and prioritizing data (so “first” is a great part of planning).
  • IMPLEMENTING: This requires doing an action with self-awareness, good communication skills (for example, acknowledging or validating the mother’s feelings) compliance with regulations, accurate documentation, etc.
  • EVALUATION: Confirm, don’t assume, that an action (for a client, or anything else) will work.

This could probably be an entire post! But this pared-down version gives you the gist for today.

The “abilities” that you’ll need to demonstrate

The biggest abilities I can think of related to application-level test items include:

  • Apply
  • Calculate
  • Classify
  • Develop
  • Examine
  • Solve
  • Use

Of these, pay special attention to “solve.” Nowadays, everything is just a “challenge,” so few test-takers have learned the classic problem-solving process. And if you can’t problem-solve, you’ll have a very tough time on the exam. 

I’m here to tell you that getting the right answer on application-level questions means you must first recall information and then be able to apply that information.

I read and respond to all questions that come in on this blog. What questions do you have about getting the right answer on application-level questions?

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