This study examined the effects of being taught the Mayfield's Four Questions multiple-choice test-taking strategy on the perceived self-efficacy and multiple-choice test scores of nursing students in a two-year associate degree program. Experimental and control groups were chosen by stratified random sampling. Subjects completed the 10-statement General Self-Efficacy survey and two additional statements based on guidelines by the survey authors and self-efficacy theorist Albert Bandura. The intervention consisted of weekly half-hour sessions to learn and practice M4Q. Survey data was statistically analyzed by group and by statement. Multiple-choice test scores were analyzed by group, level, test and test group. Statistically significant differences were found between the final experimental (n = 16) and control (n = 17) groups in post-intervention perceived self-efficacy, change in perceived self-efficacy, specific self-efficacy factors, scores on the final standardized nursing test and the mean score of the predictor tests for the licensure examination. A significant correlation was found between the number of M4Q teaching sessions attended and 2nd year students' grades on two teacher-prepared tests. Results indicate the M4Q can have a positive effect on both self-efficacy and multiple-choice test performance. Suggestions for further research were discussed. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]