I'd like to think that we all kinda know what "gets" us. For me...my mind wanders. So, I've helped to "quell the voices" by chewing gum while studying...and then when taking my test. (FYI, the other thing suggested is that however you will take the test, that is how you should study. Ergo, if you know it will be quiet, then you should study in a quiet environment. If you know there will be lots of distractions, set up your study time to include distractions...for me, it would be laundry...damned buzzer.)
The other thing I have a tendency to do is read the question and stop when I get to the first answer I believe is correct. I had to train myself to put down the pen/pencil/mouse, read the question THOROUGHLY, read ALL answers and then make my choice.
While I like to think I am a smart cookie...I'm not a genius by any means. But I can say that I passed all 4 NR-EMT exams (ECA, EMT-B, EMT-I and paramedic) first time out.
edited for grammar - need another cup of coffee...