DHA Nursing Exam common mistakes
DHA Nursing Exam · Understand the traps and how to avoid them.
Calculates the ordered dose in one step, writes the answer and moves on without computing the maximum safe dose (mg/kg/dose or mg/kg/day) to compare against it, then picks an option that is a 10-fold error or the adult dose for a child.
Under time pressure the familiar formula feels like the whole task, and the safe-range comparison is an extra step practised less often; exam writers place a plausible distractor that matches the single-step answer exactly.
What to do instead
Do every paediatric and high-alert calculation as three written lines: (a) ordered amount per administration, (b) safe range per dose and per day from weight, (c) verdict 'within range' or 'exceeds range - hold and clarify'. Reject any option you cannot trace back to those written numbers.
Chooses the option that matches how their own unit does it ('we always do it this way') rather than the published standard - routine rather than standard precautions, restraints checked every 4 hours, visitors waved through.
Workplace shortcuts become the reference frame after months of clinical exposure, and options written to sound familiar are the most attractive ones on the page.
What to do instead
Before selecting, ask 'is this the textbook standard or my unit's habit?' and name the standard supporting the option (standard precautions for every patient, restraint release and assessment per policy). Keep a list of questions answered from habit and re-study those standards.
Reads a lab value in isolation and acts on the number alone ('potassium 5.8 - give a binder') without linking it to the patient's diagnosis, medications and trend.
Single-value memorised rules are easier to recall than integrating a whole case, so the rest of the stem feels like filler and gets skimmed.
What to do instead
Before answering, state the diagnosis, the active medication list and the direction of the value; then choose the option that manages cause and immediate risk (stop the offending drug, obtain an ECG, notify) before the downstream treatment option.
Identifies a fetal heart rate deceleration by shape alone and applies the wrong intrauterine resuscitation - turning the patient and stopping oxytocin for a variable deceleration, or doing nothing for a late one.
All decelerations look similar on paper and the interventions overlap, so candidates memorise 'deceleration = danger' instead of matching pattern to mechanism.
What to do instead
Memorise a three-row table - early (head compression, benign, no intervention), variable (cord compression, reposition, amnioinfusion if ordered), late (uteroplacental insufficiency, left lateral, IV bolus, stop oxytocin, oxygen, notify) - and establish timing relative to contractions before reading the options.
Assesses a child using adult vital-sign ranges, adult expectations of pain behaviour and adult fluid volumes, then selects 'monitor and reassess' for a genuinely abnormal paediatric value.
Adult clinical exposure dominates, and candidates are unsure which age-banded range applies, so they fall back on the numbers they know best.
What to do instead
Commit to age-banded heart and respiratory rates from newborn through adolescent plus the 20 mL/kg bolus rule, and state the child's age before reading the options. Reject any option that treats the child as a small adult.
Answers 'first action' or 'initial' questions with the definitive treatment (defibrillate, intubate, give the antidote) instead of the assessment or immediate safety step, choosing the most dramatic intervention rather than the one the stem asks for.
The stress of the scenario and the 'sickest patient' bias pull attention to the intervention, and the qualifier usually sits at the end of the stem where it gets skimmed.
What to do instead
Locate and underline the qualifier (first, initial, immediate, priority, most important) before looking at the options, then apply assess - stabilise ABC - intervene - evaluate and pick the least invasive action that removes the immediate threat.
Recites PPE donning and doffing out of sequence and misclassifies organisms - placing tuberculosis or measles on droplet precautions, influenza on airborne, or using alcohol rub after Clostridioides difficile.
Both lists are memorised as one undifferentiated block, and the precaution category is chosen by how serious the disease sounds rather than by route of transmission.
What to do instead
Anchor the sequence to hand hygiene: donning gown, mask, eye protection, gloves; doffing gloves, eye protection, gown, mask, then hand hygiene. Sort organisms by route with three named examples each - airborne (tuberculosis, measles, varicella), droplet (influenza, pertussis, meningococcal meningitis), contact (MRSA, C. difficile, scabies) - and flag soap and water for C. difficile.
Defaults to 'notify the provider' for problems the nurse can and must handle independently, and freezes on advocacy or chain-of-command items with no ranked reasoning.
Escalation feels like the safest answer, and the correct action depends on a scope-of-practice hierarchy the candidate has never consciously ranked.
What to do instead
Use a fixed order: assess the patient, take the independent nursing action within scope (reposition, vital signs, hold a clearly unsafe drug per policy, voice the concern), escalate up the chain of command if unresolved, document. Choose 'call the provider' only when a prescription, order or medical decision is genuinely required.
Selects the warm-sounding response ('Don't worry, you'll be fine', 'Why do you feel that way?', 'You should try to stay positive') over the therapeutic response that names the feeling and invites exploration.
Everyday conversation rewards reassurance and advice-giving, while therapeutic technique deliberately sounds flatter and initially less helpful.
What to do instead
Strike out any option containing 'why', 'don't worry', 'you should', 'I'm sure', minimising or false reassurance. From what remains, choose the option that reflects the patient's stated feeling or asks an open, non-judgemental question.
Delegates assessment, teaching, evaluation or an unstable patient's care to assistive personnel because the task sounds simple - initial vital signs on a newly admitted chest-pain patient, teaching a new colostomy, first ambulation after surgery.
Task-based thinking makes candidates judge how easy the action is rather than whether it requires nursing judgement or a stable patient.
What to do instead
Apply three filters: does it need nursing judgement, is the patient stable, is it routine and standard? Any 'no' keeps the task with the RN. Assistive personnel take bathing, ambulation and routine vitals for stable patients and intake/output; the RN keeps first assessments, teaching, evaluation and any unstable or freshly post-operative patient.