The OITE means nothing for interns. Only a few interns across the country take it anyway (although this may have recently changed). I suggest just taking it cold turkey and not to waste your valuable sleep time on it. So if you don't know the answer, don't waste your time trying to figure it out this year.
However, after your intern year, I would try to "kick butt" on it to keep your chairman off your back and to help with fellowship hunting. Although, they are not suppose to ask about your OITE scores. However, if you do well, you can include it on your CV and in your letters of recommendations.
For the rest of the years, I would suggest reading a review book just before the test (to remember the minutiae) and going through as many old tests as you can. There are multiple repeaters (freebies). That's about all you'll need to pull away from the majority.
The whole idea of the test it to be able to compare yourself to your peers, so you know where to concentrate your self directed learning.