NCLEX-RN: Test-Taking Strategies

Test-Taking Strategies: Testing Procedures

Two categories of questions appear on NCLEX. The real questions test your competency and safety and provide the basis for your pass or fail score. The tryout questions are unscored items being field-tested for future NCLEX exams. You have no way of knowing the difference between real and tryout questions.

The minimum number of questions for each candidate is 75. The maximum number of questions that a candidate may answer during the exam period is 265.

Computer Adaptive Testing does not allow you to skip questions or go back to look at or change questions already answered. Each question has an assigned degree of difficulty. Based on your prior answers—correct or incorrect— the computer selects the next question. Therefore, you must answer each question as it is presented. Because the computer draws from a large pool of questions, each candidate’s test is unique. There is no absolute passing score in terms of the number or percentage of questions that you must answer correctly to pass.

Although there is no minimum amount of time for your test, the maximum allowable time is 6 hours. This includes your computer tutorial, sample questions, and rest breaks.

Because the number of questions is flexible, from a minimum of 75 to a maximum of 265, there is no optimal amount of time you should spend per question. However, because you won’t know how long it will take you to reach the point where the computer stops presenting questions, it is not wise to spend too much time on any one question. If you don’t know the answer, guess and move on, rather than risk becoming immobilized. When you answer questions correctly, the CAT software presents you with more difficult items. As you answer questions incorrectly, you will receive easier items.

Your test continues until the computer software calculates with a 95% degree of confidence that you fall into the safe/competent group or that you do not. The total number of questions answered does not indicate whether you have passed or failed.

Getting Your Test Results

Focus Topic: Test-Taking Strategies

NCLEX test results are available only from the state board of nursing to which you applied for approval to take the NCLEX. Do not request feedback from the Pearson Professional Center or the National Council. You can expect to receive your results within one month after taking the exam, but often in less time. A failure notice is accompanied by a performance report to help the candidate identify areas of weakness. Most state boards of nursing require that candidates who fail must wait a minimum of 45 to 91 days, depending on the state, before retaking the exam.

You can also get your “unofficial” results after 48 business hours through the quick results service available on the NCLEX Candidate Web site ($7.95).
Note: Quick results are not available in all states.

Test-Taking Strategies: Guidelines for NCLEX Review

How to Use This Book

Focus Topic: Test-Taking Strategies

Sandra Smith’s Review for NCLEX-RN ® summarizes extensive nursing content to which you have been introduced during your RN education. The material is organized into 15 chapters and presented in outline format for your review.

Nursing theory and practical applications of this theory are included for each major subject area. Nursing theory includes pathophysiology, signs and symptoms of diseases, diagnosis and treatment of medical conditions, and appropriate nursing care. Tables and appendices are distributed throughout the book to assist you to efficiently review factual material. Familiarize yourself with how the contents are organized in each chapter and how the Nursing Process is integrated throughout the book.

Other features to note for further reference include three simulated NCLEX exams at the back of the book, a detailed index, and a TestPrep with additional NCLEXtype questions.

The multiple-choice questions that follow various content review sections are similar in format, subject matter, length, and degree of difficulty to those contained in the NCLEX-RN. The answer and rationale sections provide you with additional learning. If you understand the basic principles of nursing content, you can transfer that knowledge to the clinical situations and questions on the NCLEX.

The TestPrep contains the questions printed in the book. They can be accessed for each chapter by clicking on the chapter title. This provides you with the opportunity to gain computer experience while you assess and review. Also, the TestPrep contains more than 1700 additional questions not printed in the book, for a total of more than 2500 questions.

Test-Taking Strategies

How to Design Your Personal Review Program

Focus Topic: Test-Taking Strategies

Ideally, you will begin your review process several months prior to NCLEX. If you choose to allocate only a few weeks to prepare for this exam, however, it is important that you conduct the review process in an efficient manner. The following recommendations are offered to help you achieve maximum results for the amount of time invested.

A. Schedule regular periods for study and review.

  • Arrange to study when mentally alert. Studying during periods of mental and physical fatigue reduces your efficiency.
  • Allow short breaks at relatively frequent intervals. Breaks used as rewards for hard study serve as incentives for continued concentrated effort. A 10- to 15-minute break is recommended after each hour of concentrated study.

B. Familiarize yourself with the examination format.

  • Review the NCLEX Test Plan description so that you understand the Client Needs categories. Notice which areas have the greater number of questions and allocate more review time to these topics. Refer to Table 1-1 for the allocation of questions among the subcategories of Client Needs.
  • Study the format used for NCLEX questions. You must know how to read, evaluate, and respond to multiple-choice questions similar to those in this book and on the TestPrep.

C. Identify your strengths and weaknesses.

  • Assess your past performance on classroom tests and written material (clinical pathways or nursing care plans).
  • Learn from your past errors and weaknesses by looking up and studying the appropriate material in this book.

D. Systematically study the material contained in each chapter of this book.

  • First, gain a general impression of the content unit to be reviewed. Skim over the entire section and identify the main ideas.
  • Note the tables, glossaries, and appendices.
  • The special icon (✦) that appears throughout the book’s review sections identifies nursing content that is particularly important or involves critical decision making. If an entire section is marked by an icon, then assume that all of this material is important. Do not, however, limit your study to only the icon-marked content; use the icon to help you focus and prioritize. Mark key material that you do not thoroughly understand.

E. Follow up on your priority areas.

  • Set priorities for specific material to be learned or reviewed. Identify the most crucial sections and underline the essential thoughts.
  • Review what you have read. Think of examples that illustrate the main points you have studied.
  • To be sure that you have learned the material, write down the main ideas or explain the major points to another person.

F. Test and retest.

  • Complete the clinical practice questions presented at the conclusion of each chapter as well as on the TestPrep. Study the rationale for missed questions so that you understand why you missed them. Refer back to the content outline preceding the questions to study content relating to the topics contained in the questions. Study the rationale for the questions that you answered correctly because this will reinforce your understanding of those topics and increase your confidence about material you firmly understand.
  • After you have worked your way through the clinical questions, take the first simulated NCLEX test at the back of the book. Analyze your results by noting the category of each question missed in terms of Nursing Process, Client Needs, and clinical area (see Table 1-2). This will help you identify your weaker areas. Refer to the appropriate content for further study and review.
  • Take the second and third simulated NCLEX tests. Repeat the same process of analysis and review. If you studied the content relating to questions you missed, you should see improvement. In addition to the questions printed in the book (and also contained on the TestPrep), you can utilize the TestPrep to answer more than 1700 additional practice questions (drawn at random or by clinical area). Upon answering these questions, you will receive immediate feedback—correct or incorrect—as well as the rationale. This is an excellent assessment and learning experience.
  • After you have completed the practice questions and simulated tests in the book, utilize the TestPrep for additional practice and review. The key to this process is to use the content outline in the various chapters as a learning vehicle to strengthen your grasp of the material. This, in turn, will increase your ability to apply what you know to specific clinical situations tested in the NCLEX.

Test-Taking Strategies

The following test-taking strategies will provide you with useful guidelines when answering NCLEX questions. These strategies are neither absolute nor foolproof; they are intended to guide you in choosing the best response for each question.

A. Carefully read each question. Determine what the question is really asking. Some details may not be important. Mentally note important factors; pay attention to key terms and phrases. Read the question as it is presented, not as you would like it to be stated.

B. When answering multiple-choice questions, an effective strategy is to first eliminate the answers that you know are wrong, and then focus on deciding among the remaining answers. If you are not sure about any of the four possible answers, you will have to make an educated guess. Remember, you are not allowed to skip a question, nor will you be able to change any answers that you have selected on previous questions.

C. Your first “hunch” is usually correct. Many candidates have a first impression, choose an answer, and, upon reflection, change their mind. Sensing that a particular alternative is correct has some basis. Your brain has made rapid connections. You came to an immediate conclusion based on your knowledge and experience. The fact that you did not go through the logical steps of arriving at the correct solution does not indicate that your choice is incorrect.

D. Be alert for a question that requires you to identify which answer is not correct, or a question that asks for a negative response; for example, “Which of the following interventions is inappropriate?”

E. Evaluate the answers in relation to the stem (the question), not to other answers. Choose the answer that best fits the question, rather than an answer that appears to be a correct statement but may not fit the question.

F. The most comprehensive answer is often the best choice. For example, if two alternatives seem reasonable but one answer includes the other (e.g., it is more detailed, extends the first answer, or is more comprehensive), then this answer may be the best choice.

G. Eliminate answers that are obviously different from what is logically right, such as an answer given in grams when other choices are given in milligrams.

H. Do not look for a pattern to the answers. The questions are chosen at random, and the same number may be the correct answer to several consecutive questions.

I. The test administrator will provide you with erasable note boards and a writing implement for your use during the test session. You are not allowed to bring your own notes, scratch paper, or writing implements into the test center.

Guidelines for Making Priority Decisions

Focus Topic: Test-Taking Strategies

Priority decision making is an important test-taking skill. NCLEX places increasingly greater emphasis on requiring candidates to analyze and evaluate information and then to make decisions. The following examples are presented as guidelines to help you recognize and answer priority-based NCLEX questions.

Most Life-Threatening

Focus Topic: Test-Taking Strategies

If you are asked which sign or symptom would you respond to first, or which nursing diagnosis would you identify as the priority intervention, you should determine which is the most life-threatening. Always choose the critical intervention—airway, breathing, circulation (ABC)—if one is listed as an option.

First-Priority Nursing Intervention

Focus Topic: Test-Taking Strategies

When a question focuses on which intervention you would perform first, consider which is the most immediate for the well-being of the client. For example, you would suction the client before administering a routine medication (providing it was not nitroglycerin), because medications can be given up to 30 minutes before or after the ordered time.

Safety Issue

Focus Topic: Test-Taking Strategies

The answer choices that involve a safety issue for the client will always take priority over other concerns. For example, monitoring the oxygen level in an incubator of a premature infant is a safety issue. If the oxygen level goes above 40% for the premature fetus, it could damage the retinas and lead to blindness. The oxygen level for an adult would not be a serious safety issue unless the client has COPD.


Test-Taking Strategies: Computer Testing Tips

  • When taking the NCLEX, you must answer each question that appears on the computer screen. If  you do not recognize a correct answer among thefour choices, use your test-taking skills or, if necessary, make your best guess.
  • Be certain of your answer selection before confirming your choice.
  • Take your time and carefully read each question and answer choices.
  • Do not become immobilized by any one question. Spending 5 minutes or more on a question will probably make you more nervous and less attentive as you proceed.
  • Maintain a steady pace of allocating about one minute per question. This strategy will allow you to complete the examination within the required time of 6 hours should you need to answer 265 questions.

Final Preparation

A. The night before the test.

  • Assemble materials that you will take with you to the test center, such as your ATT, identifications, and other items as specified in the NCLEX Candidate Bulletin. Do not bring textbooks, notes, or any NCLEX study aids to the test center.
  • Get a good night’s sleep. Do not stay up all night trying to learn new material.
  • Avoid the use of stimulants or depressants, either of which may affect your ability to think clearly during the test.
  • Approach the test with confidence and the determination to do your best. Think positively and concentrate on all that you do know rather than on what you think you do not know.

B. The day of the test.

  • Eat a high-protein, no-sugar breakfast. Do not rush.
  • Allow ample time to travel to your testing site, including time to park, and to present your Authorization to Test at least 30 minutes before your scheduled testing time.
  • You may wish to take a light, energizing snack and bottled water to have available for your breaks. Secure storage will be provided for your personal items.

Test-Taking Strategies: The Importance of a Confident Attitude

Anxiety, a forceful deterrent to test-taking success, interferes with your ability to think clearly. Anxiety blocks the search and retrieval process so that you cannot access the knowledge held in your “memory bank.” Fear of the unknown is a major source of anxiety. This fear can be overcome by diligent review. As you gain mastery over the nursing content, your self-confidence increases. It is also important to understand test construction and test taking strategies. This introduction is designed to reduce many of the unknowns associated with the NCLEX-RN and to provide you with helpful review guidelines and effective test-taking techniques.
These strategies are guidelines, not absolutes. Always use your own judgment, knowledge, and nursing experience. These assets will serve you well.




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