Your best bet for reviewing for the final exam is to go back over the worksheets and quizzes, and rework anything that you do not remember or had problems with at the time.

What I am going to do here is give you some tips on multiple choice tests, and testing in general. The final exam in many of your courses will be multiple choice, the ABO and NCLE exams are multiple choice, and many State Board exams are multiple choice.  There is a very good reason for this:  it is completely objective, and results in every applicant's preparation being judged equally.  Well, OK, as much so as we know how to, at this point.   And the simple but unfortunate fact is, taking multiple choice exams is a skill, not something that comes as second nature to a lot of people. So we will start with some basic recommendations, and we will finish with a bit of advise on how to read/answer multiple choice questions.

• Get a good night's sleep. Staying up unusually late to study will work against you.

That last answer that you crammed in just before the exam, whether is was the all-nighter or the books that you lugged with you to the test site, will probably not make up for the decrease in your ability to concentrate that resulted from that last-minute cramming. Yes, you might take a summary sheet of last minute items to take with you and look at before the test; but the real preparation occurred in the weeks (for finals) and months (for the boards/ABO/NCLE) before the exam.
 
• Have fresh batteries in your calculator (if allowed, which it is not on ABO/NCLE).

Do not buy a new calculator the week before the exam. If your calculator is on its last legs, get a new one enough ahead of time to allow you to become familiar with it. Remember the effort that I went through to tell you how to do sine and reverse sine depending on the type of calculator you have? Remember how long it took you to find x and inverse-sine the first time? Do not set yourself up for that extra stress just before the exam.
 
• Have your vision checked.

This one is more for the boards than for the final exam, but the boards are one reason why you are here. And really, how many of us in the eye-care profession put off our own eye exams? Since we can do it any time, we will do it later . . . That mild eye strain from not having quite the correct Rx, whether it is because you are 'young' and your vision is still changing slightly or 'my age' and the near keeps getting . . . well, anyway, that mild eye strain is not helping you cope with anything. On a stress-filled exam with all of the extra pressure on you, unnecessary eye strain is not going to help. How many people have called me up because they missed an exam by two or four points? Just that extra edge of having a little less strain to deal with [and 8 hours pretend sleep the night before] might have made the difference. Wear your correct Rx for the exam. If you are astigmatic, make sure your cylinder is fully corrected for lens neutralization if it is a part of your State Boards. Don't get the new glasses the day before the exam, either.
 
• Follow the instructions.

This one is particularly for the Boards. If you are given an applicant number and told to put it but not YOUR name on your answer sheet, do not put your name on the answer sheet!  When the proctor gives instructions actually listen!  Do not assume that you already know what the proctor is telling you to do.
 
• For the test itself:
• The first time through the exam read each question and answer the ones that you are reasonably sure you know. Do not spend a lot of time on any one question.

 

 

This is true on both the final, the ABO/NCLE, and State Boards.  You may not have limited your time on the final exam, depending on your instructor and the program you are attending.  On the ABO/NCLE and the State boards time will be called, and you want to have gotten through the whole exam at least one time. I cannot tell you how many tests I have taken [and written] where the last five questions were the easy ones. And I cannot tell you how many board applicants have told me that the time was called before they got to the last questions.
 

• Make sure that you skip an answer on the answer sheet every time you skip a question. (If the exam has a separate machine-readable answer sheet.)

 
The second time through work on each question that you skipped the first time. Make sure that you answer all of the ones that you skipped. Guess if you have to. Leave no question unanswered!

This is not like the SAT's. There is no penalty for wrong guesses. 'Wrong' and 'not answered' count the same amount. There is nothing wrong with gaining a few points for a good guess -- even if it is a lucky guess. There will not be a single question that you do not know SOMETHING about -- even if you do not know quite what is being asked. You have, at this point, some subconscious knowledge that will help you guess; your guess will be better than the guess of a person who has not gone through the material as carefully as you have. Have faith in your 'guesses.'
 

• The third time through just read. Make sure that you did not make careless mistakes the first time. If you misread a question and you are sure that the answer is wrong, change it. Erase carefully.

 

 

Here I mean actually put your pencil down. Only pick it up if you are sure that you misread the question or if you remembered something after you did that question the first time.

I did an experiment with a class recently. I gave out the 'machine-readable' forms that are used for grading ABO/NCLE and many boards, and had the students mark answers randomly for questions 1 - 12. Then I told them that all answers were 'a' and had them erase all of their answers and mark in 'a'. They KNEW that the exercise was about erasing, so they were presumably doing a good job of it. Still, 75% of them had at least one wrong answer when I machine graded the answer sheets, and several had more than 6 out of 12 wrong! That was because if the machine picks up the right answer AND an incompletely erased answer, it marks the question wrong.
 
 

• DO NOT CHANGE GUESSES.

You will change more guesses from right to wrong than you will from wrong to right. Trust me. I am right this time. Trust your first instinctive guess.
 
• Do not leave unanswered questions. You have a one in four chance of getting a question right if you just pick any answer. Unlike SAT's, wrong answers are not worse than no answer. There is absolutely nothing wrong with picking up a point for a good guess!


I said that already, didn't I?

• Have faith, when you see something that is initially unfamiliar, that you HAVE seen it -- or something close to it -- before.

 

 

Occasionally one of my graduates exits one of the board exams and tells me [or more likely someone else who then tells me] that there were questions on there they have never seen before. I promise you, by the time you finish this program, there will be very little material on the board exam that you have not seen before. It may not be a diagram that is exactly as I or another instructor drew it; but the concept and the theory behind it are there. You may have to read carefully and interpret the question to decide what it means. But you have the basic knowledge that you need to pass the exam.

It will, eventually, come down to reading comprehension. Can you read something that is phrased differently, or look at a diagram that has the information you need but is done differently, and interpret what the question is asking or the diagram is providing?
 

1. Clues in the stem.

This is basically talking about reading comprehension. You have to make sure that you noticed all of the important words in the question (the question is the ‘stem’) because those important words will help you either decide between two answers or eliminate one or two answers.

EXAMPLE:
The index of refraction of polycarbonate makes lenses
a. Lighter than CR39.
b. Heavier than CR39.
c. Thinner than CR39.
d. Thicker than CR39.

Polycarbonate is both lighter and thinner than CR39 for the comparable Rx lens. But, if you read the ‘stem’ carefully, you will note that it refers to the index of refraction. The index of refraction results in a difference in thickness; it does not directly affect the weight. In fact, when talking about glass, you can have a high index that is heavier than crown even though it is thinner; so a higher index of refraction does not necessarily mean a lower weight.
 

2. Negative questions.

This is a special case of looking for clues in the stem. Watch out for the ‘not’ or the ‘all except’ or the ‘never’. If there seems to be more than one right answer, so back and look for the negation.

EXAMPLE:
A well-dispensed, well-fitted pair of aphakic lenses should minimize all but which one of the following:
a. Decentration
b. Vertex power
c. Seg drop
d. Fitting vertex

If you do not notice the ‘all BUT which’ you would spend time trying to decide between decentration, seg drop and fitting vertex.
 

3. Specific determiners.

This is referring again to a particular word in the question that you may overlook.

Which statement is true about current polycarbonate lenses?
a. They block all UV.
b. Some block all UV.
c. Some transmit all UV.
d. They transmit all UV.

In this case the specific determiners are ‘current’ and ‘some’. The correct answer may be different for some versions of polycarbonate; note that ‘Some block all UV’ and ‘They block all UV’ are not saying the same thing.
 

4. Refer to Doctor.

The exams may very well want to know if you know when it is inappropriate for you to offer an opinion or an action -- even if you KNOW what to do.

EXAMPLE:
A C.L. patient complains of pain in his right eye. Upon biomicroscopic examination you discover an embedded foreign body. You should:
a. Use a small pair of tweezers to remove the foreign body.
b. Advise the patient to leave the contact lens out for a few days.
c. Send the patient to a Doctor.
d. Irrigate the eye with sterile saline.

For those of you who have not taken Contact Lenses and do not work in or near a Doctor's office, the biomicroscope is an instrument that is used in contact lens fitting (among other times) to get a magnified view of the cornea and adjacent areas that will be affected by the contact lens. I hope that the answer to this one is apparent to you -- as an Optician. If not, look for a clue in the paragraph immediately preceding the question!
 

5. Identify opposites.

Frequently two answers will contradict each other. So you can eliminate some possibilities by saying ‘it must be one or the other.’

EXAMPLE:
If a CL is ordered with a BC of 7.40 mm and is received with a BC of 7.45 mm it is
a. 0.25D to flat.
b. 0.25D to steep.
c. 0.50D to flat
d. 0.50D to steep

Oh, say, not fair. Some of us have not had contact lenses. No? Well, this is a chance to see how you can get your odds down to one in two instead of one in four when you guess the answer. There are two sets of opposites here: 0.25D verses 0.50D, and flat verses steep. A base curve for a contact lens is given based on the radius of curvature, not the dioptric power of the surface as it is in glasses lenses. So we are looking at a radius of curvature that should have been 7.40 mm but was instead 7.45 mm. So the radius of curvature is longer than it should have been. Does that make it flatter or steeper?

Right, it makes it flatter. So now you are guessing between a and c, and you have a 50-50 chance of getting it correct!
 

6. Equally plausible answers. That means there is more than one answer that is correct.

This type breaks down to two more types: the ones with a "both a and c are correct" type answer and the ones with one answer that is MORE right than another answer.

EXAMPLE of the “both a and c” type:
When a wave of visible light travels from a rarer material (such as air) to a denser material (such as glass)
a. the wavelength changes.
b. the frequency changes.
c. the velocity changes.
d. b and c are both correct.
e. a and c are both correct.

a is correct, c is correct, and e is correct; but e is MORE correct than either a or c.
 

7. Priority Questions.

This is the example of a case where there are several potentially correct answers, and you have to pick the best of the choices.

EXAMPLE:
Which of the following aberrations is of the greatest concern to a spectacle wearer:
a. Spherical aberration
b. Coma
c. Chromatic aberration
d. Oblique astigmatism

Each of the answers is important to some glasses wearer under certain circumstances. But the one of GREATEST concern, because it is of concern to almost all glasses wearers, is oblique astigmatism. This is what corrected curve lens designs are attempting to minimize (along with curvature of field). It is also what we are dealing with (especially in high power lenses) when we put pantoscopic tilt in the glasses with the OC below the wearer's pupil center. Do you know what the rule of thumb is for OC placement and pantoscopic tilt?
 

8. Most right.

Yet another special case of choosing between right answers.

EXAMPLE:
A CL prescription must be adjusted for VD if it is over ____ power.
a. +/- 4 D
b. +/- 7 D
c. + 8 D
d. - 6 D

Every single one of these answers is correct. If the power is over -6 D then the CL Rx will be adjusted from the glasses Rx. If the power is over +8 D the CL Rx will be adjusted. If it is over +/-7 D it will be adjusted . . . and if it is over +/-4 D it will be adjusted. And yes, that one was fair -- didn't I talk about the fact that CL Rx's have 0 VD and that if the Rx is +/-4 or more that the CL Rx will be more plus or less minus?
 

9. Least wrong.

Yet another case of choosing between wrong answers.

EXAMPLE:
The range of the visible spectrum is
a. 400 nm - 760 nm
b. 400 nm - 590 nm
c. 590 nm - 760 nm
d. 320 nm - 380 nm

Do you remember me telling you that ANSI Standards set the cut-off point between UV and visible light at 380 nm? We commonly use 400 nm because the manufacturers of our UV absorbing dye call it that. So, although the correct answer is not there, the best answer available is . . .
 

10. Excessive facts in the question.

This is where the question gives you a lot of information and you have to know enough about the subject to know what you do and do not need. If you do not read carefully you may assume that it is asking something else and do a lot of unnecessary computations.

EXAMPLE
The patient is looking 5 mm below the distance OC. What ^ is in effect from the distance Rx?
OD +2 DS, add +2.00 OU
OS +3 DS, FT 25, VD 12
a. 0.5^BI OS
b. 0.5^BU OS
c. 1.5^BU OS
d. 1.5^BD OS

It gave you a lot of information; all you needed were the +2, +3, and 5 mm below OC. Notice that this is also one with opposites? You need to choose: is it 0.5^ or 1.5^? Is it BU, BD or (giggle) BI?

On the ABO, the NCLE, and your State Boards (eventually) go in with the knowledge that you have enough of the concepts to pass the test -- you may not recognize EVERY ONE of them, but you have more than enough. Just read carefully and have faith in yourself!

1. c.
2. b.
3. a.
4. c.
5. a or c, your guess is as good as mine.
6. e.
7. d. (lower the OC 1 mm for every 2 degrees of pantoscopic tilt.)
8. a.
9. a.
10. b.




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