NCLEX-RN: Test-Taking Strategies

 Test-Taking Strategies: INTRODUCTION TO THE NCLEX

Focus topic: Test-Taking Strategies


Test-Taking Strategies


The National Council Licensure Examination for Registered Nurses, commonly abbreviated to NCLEX®, measures the licensure candidate’s competence to perform safe and effective entry-level nursing practice. This important screening test is designed and administered by the National Council of State Boards of Nursing, Inc., known as the National Council. All 50 states, the District of Columbia, and all U.S. territories are members of the Council and utilize the NCLEX as an integral part of their licensure process. The NCLEX licensure procedures define common entry-level nursing standards throughout the United States while providing healthcare protection to consumers. Licensed nurses have reciprocity from state to state, an additional benefit provided by a national licensure system.

In addition the Nurse Licensure Compact (NLC) enables multistate licensure for nurses. This allows nurses to have one multistate license, with the ability to practice in both their home state and other participating states. A complete listing of the compact states can be found at

Test-Taking Strategies: Developing the NCLEX-RN®

Focus topic: Test-Taking Strategies

The National Council contracts with clinical nurses and nurse educators to write questions (referred to as test items) that test your ability to apply your knowledge of nursing. The test questions focus on job tasks normally performed by entry-level RNs during their first 6 to 12 months on the job. The National Council identifies these tasks by conducting extensive surveys, called RN  practice analyses, about every three years. It is possible that your RN program may have included instruction on certain tasks that are not considered to be entry level by the National Council’s job surveys. It is also possible that your program may not have provided you with instruction on some of the tasks about which questions have been included in the current test pool.

The practice analysis activities are analyzed by frequency of their performance, priority, and their impact on maintaining client safety. The results guide the development of the NCLEX-RN Test Plan framework based upon specific client needs. On a continuing basis, the practice analysis studies are also used to help validate the current Test Plan and to provide the basis for selecting subjects to be covered by NCLEX.

The Test Plan serves as a guide for examination development and candidate preparation. Each test reflects the knowledge, skills, and abilities necessary for each nurse to safely meet client needs for the promotion, maintenance, and restoration of health.

Test-Taking Strategies: CLIENT NEEDS

Focus topic: Test-Taking Strategies

The basic framework for the NCLEX is Client Needs. The health needs of clients are organized into four major categories and six subcategories. This section reviews Client Needs so that you can understand how NCLEX is structured and what material you need to master to pass this examination. The NCLEX questions are proportional according to a survey conducted every 3 years by the National Council.

Test-Taking Strategies: Safe, Effective Care Environment (26–38%)

Focus topic: Test-Taking Strategies

To meet the client’s needs for safe, effective care, the nurse must be able to provide nursing care in the following areas:

  • Management of Care—providing and directing nursing care to protect clients, family, significant others, and healthcare personnel. The related content encompasses advance directives, management and delegating, and legal responsibilities. There are a total of 19 subcategories of Management of Care.
  • Safety and Infection Control—protecting clients, family, significant others, and healthcare personnel from environmental hazards. Related content includes topics such as accidents and disasters, asepsis, safety, and standard precautions.


Test-Taking Strategies: Health Promotion and Maintenance (6–12%)

Focus topic: Test-Taking Strategies

The nurse provides and directs nursing care for the client and family/significant others that incorporates the knowledge of expected growth and development principles, prevention, and/or early detection of health problems, and strategies to achieve optimal health. Related content includes such topics as aging and newborn care, family disease prevention, and health promotion activities.

Test-Taking Strategies: Psychosocial Integrity (6–12%)

Focus topic: Test-Taking Strategies

The nurse provides and directs nursing care that promotes and supports the emotional, mental, and social well-being of the client and family/significant others experiencing stressful events as well as clients with acute or chronic mental illness. Related content includes but is not limited to such topics as chemical dependency, crisis, family dynamics, psychopathology, and therapeutic communication.

Test-Taking Strategies: Physiological Integrity (42–66%)

Focus topic: Test-Taking Strategies

The final category is the largest and applies to an average of 50% of the questions. This category relates to meeting the client’s needs for physiological integrity— including acute and/or chronically recurring physiological conditions—as well as potential complications.

  • Basic Care and Comfort—providing comfort and assistance in the performance of activities of daily living.
  • Pharmacological and Parenteral Therapies—providing care related to the administration of medication and parenteral therapies.
  • Reduction of Risk Potential—reducing the likelihood that clients will develop complications or health problems related to existing conditions, treatments, or procedures.
  • Physiological Adaptation—providing care to clients with acute, chronic, or life-threatening physical health conditions.

Test-Taking Strategies: Integrated Processes

Focus topic: Test-Taking Strategies

The following processes, fundamental to the practice of nursing, are integrated throughout the four major Client Needs categories. NCLEX questions will reflect these processes. They include:

  • Nursing Process—a scientific problem-solving approach to client care.
  • Caring—interaction of the nurse and client in an atmosphere of mutual respect and trust.
  • Communication and Documentation—verbal and nonverbal interactions between the nurse and the client, the client’s significant others and other members of the healthcare team.
  • Teaching/Learning—knowledge, skills, and attitudes promoting a change in behavior.

Because the NCLEX-RN Test Plan centers on the categories of Client Needs, you may wish to visit the National Council’s Web site at Detailed information will help guide your review process, as it lists specific nursing actions in relation to Client Needs in each of the Nursing Process categories.

Test-Taking Strategies: Nursing Process

Focus topic: Test-Taking Strategies

The National Council no longer provides a percentage breakdown of questions according to the individual phases of the Nursing Process. However, the Nursing Process continues to be an integral foundation for nursing education, clinical training, and textbooks. Therefore, it is appropriate for you to understand the concepts and to be able to relate NCLEX questions to the Nursing Process as you apply your knowledge of nursing to select the correct answers.
The five phases of the Nursing Process are Assessment, Analysis, Planning, Implementation, and Evaluation. The Nursing Process is a frequently used, but often misunderstood, term. By definition, a process is a series of actions that lead toward a particular result. When attached to nursing, the term Nursing Process becomes a general description of a nurse’s job: assessing, analyzing, planning, implementing, and evaluating. Ideally, this process of decision making results in optimal health care for the clients. While the five steps can be described separately and in logical order, in practice the steps will overlap and events may not always occur in the order listed above, especially when the unexpected happens.

Test-Taking Strategies: Assessment

Focus topic: Test-Taking Strategies

The assessment phase refers to the establishment of a database for a specific client. Assessment requires skilled observation, reasoning, and a theoretical knowledge base to gather and differentiate data, verify data, and document findings. The nurse gathers information relevant to the client and then assigns meaning to these data. Assessment is a very critical phase because all other steps in the Nursing Process depend on the accuracy and reliability of the assessment process.

Test-Taking Strategies: Analysis/Nursing Diagnosis

Focus topic: Test-Taking Strategies

The analysis phase focuses on the comprehension and the interpretation of data collected during assessment for the purpose of goal formulation. This phase includes identifying client needs, choosing the appropriate nursing diagnosis, and setting goals. Developing a plan of action for goal achievement follows this.

Test-Taking Strategies: Planning

Focus topic: Test-Taking Strategies

Based on data collected, the planning phase refers to setting goals for meeting client needs and identifying nursing actions (strategies) to achieve the goals of care. This phase of the Nursing Process also includes nursing measures for the delivery of care. Clients may be involved in the planning phase.

Test-Taking Strategies: Implementation

Focus topic: Test-Taking Strategies

The fourth phase of the Nursing Process is implementation, or intervention. It explicitly describes the action component of the Nursing Process. This phase involves initiating and completing those nursing actions necessary to accomplish the identified client goals. Implementation includes performing basic therapeutic and preventive nursing measures, providing a safe and effective environment, recording and reporting specific information, and assisting the client to understand the care plan. Implementation of the plan involves giving direct care to accomplish the specified goal.

Test-Taking Strategies: Evaluation

Focus topic: Test-Taking Strategies

The final phase of the Nursing Process is evaluation, or determining the extent to which identified goals were achieved. Evaluation is the examination of the outcome of the nursing interventions. This process is extremely important, because without this step, the nursing plan cannot be evaluated and adapted to the client’s ongoing needs.

Test-Taking Strategies: Critical Thinking

Focus topic: Test-Taking Strategies

All nurses are required to use critical thinking skills. Critical thinking competencies are the cognitive processes that a nurse employs to make clinical judgments, including diagnostic reasoning and decision making. The Nursing Process is the framework for critical thinking competency in nursing.

  • Assessment: Obtaining, classifying, and organizing data are principal components of critical thinking.
  • Analysis/Nursing Diagnosis: The nurse critically analyzes, synthesizes, clusters, and interprets all the collected data before formulating a Nursing Diagnosis.
  • Planning: Defining realistic goals (both short and long term) and prioritizing these goals also requires critical thinking. The nurse must sort through the available information, evaluate the goals, determine the probable outcomes (which must be time specific), and prioritize them. This is a key step in the critical thinking process.
  • Implementation: The fourth component of critical thinking is based on strategies designed to achieve positive outcomes. Deciding on the appropriate actions (after considering all those possible), while examining the risks and consequences of each action, completes this step in the process.
  • Evaluation: Critical analysis of each of the client outcomes is the final step. Was the goal achieved? If not, the plan is revised.

Test-Taking Strategies: The Nclex-Rn Test Plan

Focus topic: Test-Taking Strategies

To plan an efficient and effective study and review program, it is important that you understand both the purpose and framework of the NCLEX. This examination is designed to measure your ability to practice entry-level nursing in a safe, competent manner. NCLEX questions are designed to require you to apply your knowledge of nursing care and procedures to specific clinical situations. When you take the NCLEX,you will complete a brief computer tutorial, which includes examples of the various types of questions that you may encounter. The tutorial is accessible at

Test-Taking Strategies: Levels of Cognitive Ability

Focus topic: Test-Taking Strategies

Cognitive levels are defined in taxonomy as “the orderly classification of data into appropriate categories on the basis of relationships between them.” The practice of nursing requires application of knowledge at various levels of cognitive domain underlying theory, skills, and ability. The majority of the NCLEX-RN questions are written at the more advanced levels of application and analysis rather than at the lower levels of knowledge or comprehension. The taxonomy of cognitive levels is as follows.

  • Knowledge: Recall or recognize theoretical principles or facts of nursing content. Questions ask the nurse to define, identify, recognize, or select the appropriate data.
  • Comprehension: Understand the information presented. Questions ask the nurse to explain, interpret, predict, or distinguish data.
  • Application: Apply or use information in a new or different manner. Questions ask the nurse to problem solve, change or manipulate data, or use the information appropriately.
  • Analysis: Separate parts of the whole or determine relationships between parts for a new understanding. Questions ask the nurse to analyze, differentiate, evaluate, or interpret data from a variety of sources.
  • Synthesis: The highest level of cognitive functioning, which puts information together in a totally new and meaningful way.

The questions in this book have been coded according to cognitive levels. While all levels are represented, most questions are written at the application and analysis levels. Understanding this component of the test is important because as a licensure candidate, you cannot expect to simply memorize data and recall it for the examination (knowledge level) or interpret data (comprehension level). Rather, most questions will require that you apply your knowledge to clinical problems. This requires application of the data.



Focus topic: Test-Taking Strategies

As a candidate for RN licensure, you will deal with several organizations as you complete your application procedures to take the NCLEX. The key organization is the board of nursing in the state or jurisdiction where you plan to practice. Each state board of nursing sets education and other eligibility requirements for RN licensure. Fortunately, all states and territories accept the NCLEX as the standard licensure examination. Assuming you qualify, the state board will send you an Authorization to Test (ATT). Now you are authorized to contact a Pearson Professional Center of your choice to schedule your test session. The center does not have to be located in the state where you plan to practice. As a first-time test taker, you should be able to schedule your test within 30 days of receiving your ATT.

When you receive your ATT from the board of nursing, note its expiration date. You must take the NCLEX before the ATT expires, or you will have to reapply and pay the filing fees again. You should also be aware that the Pearson Professional Centers are highly booked at certain times of the year, especially May through July, so plan your testing date accordingly. Sometimes test takers go to an adjoining state that may have more availability.

The NCLEX Candidate Bulletin contains a description of computerized adaptive testing and important information regarding NCLEX registration, scheduling, and other important procedures. Published by the National Council of State Boards of Nursing, this useful resource is available via the Internet at

Candidates whose applications for licensure have been approved are eligible for an interim permit to practice under the direct supervision of a registered nurse. However, this permit is not renewable and is in effect until its expiration date or until the results of NCLEX are mailed to you. These procedures give you strong incentive to pass the NCLEX on your first attempt.

Test-Taking Strategies: Taking The Nclex

Focus topic: Test-Taking Strategies

Upon arriving at the Pearson Professional Center, you will present your Authorization to Test and two forms of identification, both signed and one with a photo. A driver’s license, school or employee ID, and passport are the most accepted forms. At check-in, you will be photographed and thumb printed. Before commencing the test questions, you will complete a brief computer tutorial to make certain that you are comfortable with the testing procedures. The National Council advises that no prior computer experience is necessary for Computer Adaptive Testing (CAT). The Navigate Test Prep accompanying this book allows you to practice and become comfortable with CAT procedures.




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