Coaching with Ping

I know the material. Why do I blank on my licensing exam?

By coachingwithping.com. Updated October 2026.

Your practice scores are at or near passing. Then you sit down for the real thing, the first question doesn’t make sense, and the rule you knew comes back on the drive home. If you’ve already missed once, even opening a practice block now brings the same dread.

You haven’t lost what you studied. Stress at the moment you try to recall something makes it harder to get out, and after a failed attempt the dread starts earlier, in practice and in the weeks before. Two things help: changing how you practise, and working on the dread itself, whether you’re facing the bar, your boards, the NCLEX, the CPA or the PE.

Why does my mind go blank when I know it?

Stress just before or during recall makes recall worse. A 2017 review found the effect is real and, on average, modest, and larger for emotionally loaded material. One study found that stress hurt free recall but not recall with a prompt, which matches the experience of the answer coming back the moment you see a hint.

Worry also takes up working memory, the mental space you use to hold a question and reason through it. I’ve written more about that side of it in why your mind goes blank when someone asks you a question.

On professional exams, test anxiety accounts for about 5% of the differences in scores, according to the bar examiners’ own summary of the research. That’s modest on average. If you missed by a few points, though, a modest effect can be enough to decide the result.

Why is the retake so much harder?

In 2025, 76% of first-time bar takers passed, compared with 34% of repeaters. For the NCLEX-RN in 2024, the rates were 91% and 51% for US-educated nurses. Much of that gap reflects who ends up repeating, such as people with bigger content gaps or harder circumstances, so the numbers don’t show that anxiety causes it. They do show why a second attempt feels heavier than the first.

An article in the bar examiners’ own journal describes the loop. A disappointing score makes the anxiety worse, the anxiety gets in the way next time, and the cycle can go on for years. The author’s view is that retaking without working on what got in the way is unlikely to change the result.

Why do practice questions make my anxiety worse?

In two experiments, people who took practice quizzes under high stakes learned less from them than people who took the same quizzes under low stakes, even though both groups scored the same on the quizzes themselves. After a failed attempt, every practice block can start to feel like a verdict on you, and you may be getting less out of it as a result. Many retakers start avoiding full-length practice exams for the same reason, and then feel less prepared.

What to do in the weeks before

  1. Sort last time’s misses into two piles. One pile is things you didn’t know, and the other is things you knew and couldn’t get out. The first needs a content plan. The second needs work on the anxiety, and more questions won’t fix it.
  2. Make most of your practice low-stakes. Use untimed or tutor mode for learning, and keep a smaller number of timed blocks for rehearsing exam conditions. Try not to read each percentage as a prediction.
  3. Keep testing yourself rather than rereading. In a study of 120 people, those who had learned material by testing themselves recalled about as much under stress as without it. Those who had learned it by rereading recalled noticeably less under stress.
  4. Step back into exam conditions gradually. Start with one timed block, then a half-length, then a full-length at the real start time. If you can, visit the test centre beforehand. A review of 44 trials found that treating test anxiety lowered it and improved grades, and behaviour therapy, the approach this step-by-step ladder borrows from, had the most support.
  5. Protect your sleep across the weeks. In one study that tracked sleep with wearables, sleep over the previous week and month predicted grades, and sleep on the night before didn’t. One restless night matters less than you fear.
  6. Go easy on yourself about the last attempt. In an experiment on failure, people who were encouraged to be kind to themselves after failing a hard test studied longer for the retest than people who were given a confidence boost.

On the morning and in the exam room

Expect your body to rev up, and tell yourself it’s getting ready. In one study, people who were told before a real standardized exam that feeling anxious could help them scored noticeably higher on its math section than people who weren’t told. Only 28 people were analysed, but a later trial with 339 people found higher exam scores too.

When you go blank, stop forcing it. Take a few slow breaths with a long exhale, flag the question and move on. When you come back, picture where you learned the answer, like the page or the explanation screen, and write down any fragment that comes. Recalling the setting where you learned something helps memory in lab studies.

If a section goes badly, try not to decide halfway through that you’ve failed. Bank what you can and keep going.

Writing your worries down for ten minutes before an exam is widely recommended, based on a 2011 study. It didn’t hold up when a large project repeated it, and a 2026 review of 21 studies found the effect negligible. If writing settles you, do it, but don’t rely on it for points.

Can EMDR or coaching help with test anxiety?

Working on the anxiety directly has better support than study tips alone. In one clinical series, 72 doctors and doctors in training who had failed a medical licensing or specialty board exam received behavioural treatment for test anxiety, and 93% eventually passed. There was no comparison group, so take it as encouraging rather than proof.

EMDR has one small controlled trial for test anxiety. A single 90-minute session moved 17 people’s test anxiety scores from around the 90th percentile to around the 50th, and the change held through their next exams. The participants were undergraduates rather than people facing a licensing exam, the study didn’t measure exam scores, and reviews rate the evidence as thin. I use tools from EMDR because they aim at the two things that seem to keep retake dread going, the memory of the failed attempt and the picture of the exam room. No study shows they raise scores.

If your exam is a few weeks out, this is the kind of work the Intensive is for. We meet three to four weeks before the exam and work on the moments you dread, such as opening the first block or the score email, along with the memory of last time. Then we rehearse the exam morning step by step, and the first of the two follow-up calls lands before exam day.

Accommodations, medication and when to see someone else

Licensing exams are covered by disability law in the US, but “test anxiety” on its own rarely qualifies for accommodations. Boards usually want a diagnosed condition, a description of how it limits you, and recent paperwork. USMLE asks for documentation from within the past six months, and NCBE’s guidelines for the MPRE ask for an evaluation from within the past twelve. For the bar itself, each jurisdiction runs its own accommodations process, so check with yours, and start months ahead.

Beta blockers such as propranolol come up a lot. The evidence for exam performance is thin, and whether they’re right for you is a question for your doctor. Never take a medication for the first time on exam day.

Please see a doctor or therapist, and not only a coach, if you have panic attacks outside exams, if you wonder whether ADHD is part of the picture, or if you’re sleeping badly or drinking more to get through it. If you feel hopeless or have thoughts of harming yourself, call or text 988 in the US or Canada, or call Samaritans on 116 123 in the UK and Ireland.

Sources

I’m Ping. I was a trauma therapist for more than a decade, and now I offer EMDR-informed coaching one-on-one, online. This is coaching, and it isn’t therapy or a substitute for it.

If you have an exam date and the dread has started showing up in practice, say hi below. A free call is enough to see whether the timing works.

Want to talk it through?

Tell me a little about what’s in the way. I’ll write back within two business days with a time for a free 15‑minute video call.

We’ll talk about what’s going on and whether this is the right fit. If it isn’t, I’ll say so, and try to point you somewhere better.

— Ping