I worked with a pinoy nurse who had failed her state boards exams. The psyche test is what got her. I talked to her about it and she said the test used American slang which she didn't always understand. I asked her for an example. She said the question was; "You are the nurse and your patient says to you,"I am at the end of my rope." What would you say to the patient?" She said, "All I could picture was a man holding on to the end of a rope. What the hell was I supposed to say?"