I agree with the others telling you to skip troublesome questions and come back to them later. Just make sure that you mark the questions that you are skipping, on your answer grid, so that you do not accidentally plug in an answer that belongs to a different question. That could really screw you up. Just be careful. DO NOT obsess over any one question, until you are done with all the other questions. Make sure that you tab and label your books too. It makes for a quicker way of flipping to the pages/section that you're looking for. It helped me tons. Timing is KEY when taking these tests. It may sound dumb, but every second counts.
Be sure not to go on an empty stomach. Being hungry makes the mind unfocused.
Also, I found that it really helped with my timing to eliminate any answers that contain ICD-9 codes which I was sure did not correctly answer the question.
Good luck! Get enough rest tonight. I'm sure you'll do great. Let us know when you pass!
I wanted to add to this...when marking your answers in the grid, pay CLOSE attention to what question number you're filling in - the answer key has the questions grouped 10 at a time, in 3 columns, and if you're not paying attention, you can fill in answers in the wrong place (for example, instead of filling in the answer for #11 in the right place, you might accidentally fill it into #61, thinking that you're on #11.) They're numbered, so it's not hard to do it right, but if you're worried about getting through the test in time, you might forget to look.
Bring something to sit on, like a small pillow or a blanket. You never know what kind of chair you'll have to sit in, and if it's hard and uncomfortable, it makes for a miserable 5 1/2 hours (not to mention that having a sore butt is
really distracting). And speaking of distractions, if you are distracted easily when taking tests, bring earplugs to drown out ambient noises - just don't put them in until the test starts!
Bring a highlighter and make sure that your pencil has a good eraser (really, it's better to have 2 or 3 pencils in case one breaks, but the proctors usually have extra ones, if you forget).
I agree with everyone else about not getting hung up on hard questions - I go through the entire test, and knock out ALL of the easy ones first - if I can answer it in under 10 seconds (at a glance, or with minimal searching for codes), I'll answer it on the first round, but if it's a longer question, or one with a multi-part answer, I don't even read it until the second round. (Hint: I don't know if it's still like this, but when I took the test, medical terminology was one of the very last sections...) Once I've gotten all of the obvious ones out of the way, it's all about the process of elimination, which I've already told you about in another post.
Another thing I suggest is, in your test booklet, don't just circle the answer; write the letter you chose out to the side of the question #, where it's easy to see on the edge of the page. It will help you at the end as you're checking to make sure you filled in the answers on the grid correctly (since you won't be losing your place by searching through the actual answers), and it will also help to draw attention to questions that you skipped over earlier - don't leave any questions unanswered - even if you guess, you've still got at least a 25% chance of getting it right.
Finally, I've got an emergency back-up plan if you get to the point that you're desperate, to help you avoid panicking in the last few minutes:
If you're not anywhere near being done, at the start of the last hour (like, 30 or more questions),
lightly fill in the
same answer on all of the ones you still have open (eg, make them all A's),
then spend time going over the questions and taking your best shot at picking the right answers with the time you have left - you have to fill the dummy answers in lightly 1) so you can tell them apart from other questions you've already answered with the same letter, and 2) so it can be easily erased when you replace it with the answer you choose. Try to get through as many as you can; but if you run out of time, you'll at least have all of the answers filled out.
I'm sure you'll do great! Just keep in mind that you get a free retake - but tell yourself that you're not going to have to use it!
Good luck!