My approach (I made 5's on both lang/comp and lit) was to read the passage carefully first and underline sentences that I thought were key ideas. We had to do a fair number of practice MC sections in my HS English classes, so by the time the exam came around, I had a feel for what kinds of questions would show up.
After reading the passage fairly carefully, I would then go through the questions quickly. If I read a question and came up with an answer, I would look at the list to see if I was completely off base/see if something listed sounded better than my original thought. If my answer was the best, I'd mark it down. If something else seemed better, I would cross off all the answers I thought were wrong and move on. And if I read the question and had no idea, I would skip it. I usually knocked out 1/2 - 2/3 on the first pass.
The idea is to get everything into your head. There are some schools of psychological thought that believe your brain subconsciously thinks about unsolved problems, so I felt it would be good to get a glimpse of the problems I was facing.
After the first pass, I would begin with the first question that I didn't answer and look in the text for more details (scanning this time, not reading carefully). If I found an answer to a different question while doing this, I'd switch gears, answer that, and come back. But I'd take care to not spend too much time on any one question. If I was still getting stuck, I'd skip the question a second time.
I never made more than 3 consecutive passes through questions for a passage. If I was still stuck, I would move on to the next passage and revisit the blank ones at the end if there was time.
Keep in mind that you don't have to get ALL of them right! If you aren't sure, leave it and move on. No big deal. And I can't remember if you're marked off for guessing... but if you aren't, make sure you guess!
Good luck,
-Eric
Btw, I ****** HATE english. Haven't taken another BS english course since AP Lit in HS.
Edit: I should add that I'm a pretty slow reader, so my test method is designed around my reading speed. Quick reading fails for me because I won't retain any of the information.