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The 70-441 exam focuses heavily on designing databases from the ground up. This includes data types, constraints, tables and relationships between tables, VIEWs, stored procedures, triggers, database security, and more. While the preparation guide indicates that you need to be an expert in T-SQL, the exam doesn't directly test this knowledge. Instead of coding, you need to have a solid knowledge of the underlying concepts.
This is a design exam. Unless you've taken a design exam before, ...