Studying for your NCLEX can be stressful. Your future career as a nurse depends on passing the licensure examination. What are some ways to be confident on your Test Day?
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1
Plan and Prepare
Your education and clinical rotations covered everything you need to know as a new nurse. Now it’s time to apply that knowledge and organize it into the categories that will be on the exam.
The National Council of State Boards of Nursing (NCSBN) plans and administers the NCLEX. If you haven’t already downloaded a copy of your NCLEX-RN or NCLEX-PN Test Plan, do it right away. The Test Plan provides an overview of exam, details about each category and sub-category, and sample questions. The Test Plan is updated every two years, so you’ll find information about the current NCLEX for your RN or PN licensure.
Once you’ve studied the NCLEX Test Plan, make a calendar to cover the categories and understand how test items are constructed. These Nurse Plus articles are helpful:
NCLEX Study Guide
How to Develop Your Personal NCLEX Study Plan
Anatomy of an NCLEX Question
Types of NCLEX Questions and How They Are Written
Learn to “Speak NCLEX” Before Your Test Day
Goals for a successful NCLEX preparation include becoming familiar with the test items. The result: You’ll be relaxed and confident on Test Day!
NCLEX is not meant to be misleading. There are no “trick” questions. However, the test items are written to evaluate your knowledge of topics and ability to apply information that will allow you to provide safe client care. Some of the possible options will seem very close to the correct answer, as a way of determining your ability to analyze the situation.
If you are unsure about which response to choose, there are a few helpful hints that can increase your chances of selecting the BEST option. We can’t promise these tips will ensure that you pass—the preparation is up to you—but some general guidelines are useful if you are truly stuck.
If the question has words or phrases like PRIORITY, MOST IMPORTANT, or IMMEDIATE ACTION, choose the option that will result in patient harm or death if it’s not done.
For possible interventions, select the least invasive option first.
If uncertain about the correct action, choose the one that includes “stay with the patient.”
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Let’s “Talk” About Communication: Do NOT!
Do NOT ask “Why?” questions to elicit a response.
Do NOT say “Don’t Worry!” if a client seems anxious or scared.
Do NOT ask “Yes” or “No” questions—except with possible self-harm.
Do NOT try to persuade the client.
Let’s “Talk” More About Communication: DO!
DO respond to the feelings behind the words.
DO allow for silence to let the client speak.
DO focus on the client’s nonverbal message.
DO provide information to the client.
Secondhand Information: The Correct Answer is ASSESS!
Comments from the client’s family
Reports from UAP or other team members
Laboratory results
Vital signs, ECG, X-rays, etc.
Default Answers: When you have a question about:
Reversal from normal findings, assess and report. Example: Rebound tenderness—client pain following the relief of pressure
Neuro clients: Head of bed is elevated 30-45 degrees
Rapid onset of confusion in the elderly: Assess for a UTI
GI complication or exacerbation: Make client NPO
Post-op risks: First 24 hours: Bleeding; First 48 hours: Infection
Fluid imbalances: Check daily weight
Sudden restlessness and decrease in consciousness: Assess respiratory status. The first sign of hypoxia is restlessness.
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3
Think Like a Nurse
Which Client Should You Assess First?
NCLEX will have questions on prioritizing. Expect to see test items with a list of clients, ending with “Which client will you see or assess FIRST?” Always consider:
ABCs
Unstable vs Stable
Unexpected vs Expected
Actual vs Potential
Acute vs Chronic
How to Assign or Delegate Tasks?
Only RNs can “EAT” (Evaluate, Assess, Teach)
LPN/LVN: Assign stable clients with expected outcomes
UAP: Delegate standard, unchanging procedures or tasks
Children AND Abdomen: Inspection, Auscultation, Percussion, Palpation: Palpation and percussion can alter bowel sounds, so the order is changed: Inspect, Auscultate, Percuss, then Palpate.
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Are you familiar with the Glasgow Coma Scale?
The range for each assessment is 3-15
Rule of Thumb: If less than 8, INTUBATE!
Decorticate response to noxious stimulation: Flexion toward the body’s “core.” Decorticate positioning involves the CORTEX of the brain.
Decerebrate response to noxious stimulation: Abnormal extension. Involves the cerebellar and brain stem: much more serious, indicating herniation.
Image credit: Pixabay
4
Learn the Hallmark Signs and Symptoms
Autoimmune Diseases:
Diabetes, Type 1: Three Ps: Polyuria, polydipsia, polyphagia
You’ll find many tips, hints, and tricks for passing your NCLEX. Everyone has a different learning style and strategy for retaining information. Our list is not meant to be comprehensive; it’s a way to get you thinking about how to organize your preparation. There is no way of knowing what test items will be on your examination.
The best approach is to:
Develop a solid study plan—and stick with it!
Take as many practice tests as possible. Keep track of questions and topics that you need to review.
Refer to your nursing books and notes to find out more about subjects you’re not familiar with.
Use flashcards, mnemonics, diagrams, or other learning tools to help you remember.
Learn about the different types of test items you’ll encounter on NCLEX.
Take time to understand how NCLEX test items are written, so you’ll be confident on your Test Day.
Everyone at Nurse Plus is cheering for you. Good luck in your nursing career!
About the Author
Winona Suzanne Ball
Nursing Adviser, RN | MHS, Governors State University, IL Full member of the American Nurses Association. Learn more
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You must always figure out what the question is asking, and you must always eliminate answer choices. Choosing the right answer often involves choosing the best of several answers that have correct information. This may entail your correct analysis and interpretation of what the question is really asking.
You must always figure out what the question is asking, and you must always eliminate answer choices. Choosing the right answer often involves choosing the best of several answers that have correct information. This may entail your correct analysis and interpretation of what the question is really asking.
Take as many practice tests as possible. Keep track of questions and topics that you need to review. Refer to your nursing books and notes to find out more about subjects you're not familiar with. Use flashcards, mnemonics, diagrams, or other learning tools to help you remember.
The Pearson Vue Trick is a quick method to check your NCLEX exam results for free. This trick involves attempting to re-register for the NCLEX exam immediately after receiving the exam completion email from Pearson. If you have passed the NCLEX exam, you cannot register again.
always, never, all, and only. These words do not allow for the possibility of an exception, and therefore the answers that contain these words can be automatically eliminated. Never choose an answer that describes the nurse's actions as "vigorous."
Each category of questions requires an increasing level of critical thinking skills. Analysis, synthesis and evaluation questions would be considered higher-level NCLEX questions. Synthesis questions are based on creating or proposing solutions, such as a plan of care.
The number of unsuccessful test-takers is low compared to the more than 86% who pass the exam on their first try. Candidates who fail the NCLEX-RN can retest forty-five days after their most recent attempt. Being alert for signs you failed the NCLEX-RN will help you prepare before receiving official results.
Failing the test can result in not answering the minimum amount of 70 questions within the allotted time. You can answer the first 69 questions correctly, but you will automatically fail the exam if you don't reach number 70.
The first fifteen questions are pretest items and are not used to score the exam and determine if a test-taker has passed the NCLEX-RN. Not all candidates will answer the maximum number of questions. However, everyone who takes the exam must complete a minimum of 75 questions.
Run-out-of-time (R.O.O.T.) Rule: If a candidate runs out of time before reaching the maximum number of items and the computer has not determined with 95% certainty whether the candidate has passed or failed, alternate criteria are used.
An important aspect of exposure to NCLEX® questions is establishing a realistic practice setting. Avoid distractions, don't look up answers during your exam, focus on your thinking to come up with the correct answer! Pull together practice question resources that will expose you to a minimum of 3500 questions.
Does 145 questions on NCLEX mean you failed? No, if you answer all 145 questions on the NCLEX, that does not mean you fail. In fact, if you answered 145 questions and each question was progressively more challenging, then that is a good sign that you passed.
While it is certainly possible to fail the NCLEX-RN or NCLEX-PN evaluation in only 75 questions, this rarely happens because most nursing students are far more prepared than they believe they are.
The only way you will receive your official results is through your nursing regulatory body. This takes place approximately six weeks after you take the NCLEX. Some things to note: If you have not received your results after six weeks, contact your nursing regulatory body.
What topics are covered on the NCLEX? NCLEX comprises eight main client need categories: Management of Care, Safety and Infection Control, Health Promotion and Maintenance, Psychosocial Integrity, Basic Care and Comfort, Pharmacology, Reduction of Risk, and Physiological Adaptation.
If the last question is below the level of difficulty needed to pass, the candidate fails. If the last question is above the level of difficulty needed to pass, the candidate passes.
What are NCLEX Priority Questions? Priority questions are designed to test your conceptual comprehension. They are generally written at the analysis level, meaning you'll need to analyze the choices and apply your knowledge in order to answer the question correctly.
The NCLEX is scored using dichotomous scoring, so you can either pass or fail the exam. Currently, to pass the NCLEX-RN, the standard is 0.00 logits–or answer questions correctly at least 50% of the time.
New Hampshire boasts the highest NCLEX pass rate average in the U.S., over 14% higher than the national average. In 2022, five of the state's eight bachelor of science in nursing (BSN) programs reported first-time pass rates above 90%, including a 100% rate for Plymouth State University.
You answered the least number of questions possible, which is 75. As mentioned in #2, the NCLEX progresses variably, depending on whether you answer a question correctly or incorrectly. If your questions continually got more complex and the test shut off at 75, this is another good sign you passed the NCLEX.
A test-taker must have answered the minimum number of required test questions to be eligible to pass. For examinees taking the NCLEX-RN, at least 75 questions must be answered. A minimum of 85 questions must be completed on the NCLEX-PN exam.
When studying for the NCLEX, a good idea is to set a practice question goal for yourself to observe and answer a certain amount of questions before exam day. We recommend that you complete about 2,800 practice questions before your exam.
Easy questions on the NCLEX are questions that are lower on Bloom's taxonomy level. These are memorization style questions that do not require any critical thinking or application.
UWorld found that about 90% of users who took the NCLEX report that the Questions on UWorld were either at the same difficulty level as the NCLEX or harder.
What should I do the night before the NCLEX? Twas the night before the NCLEX, and you're getting exam day jitters! This is the perfect time to take a deep breathe, relax, meditate, and tell yourself some positive affirmatives. Also, sleep, sleep, sleep!
2. The “bad” email: You get a Candidate Performance Report (CPR) Candidate performance reports are only sent to people who failed the NCLEX, so if you get one emailed to you, then, unfortunately, you have not passed. This is 100% accurate.
In general, it's recommended that you take the NCLEX in the morning so your mind is the most “fresh,” but everyone is different—schedule your test for the time you will be at your best.
To pass the NCLEX RN or PN, test takers must correctly answer at least 85 questions (the minimum amount). Unfortunately, that means you can also fail the exam within those 85 questions or items.
If the last question on the NCLEX was easy, it means you got a question that was easy or a topic you knew very well. While that could be a sign you passed, you won't know for sure until the official results are available.
The NCSBN Board of Directors voted in December 2022, to uphold the current passing standard of -0.18 logits for the NCLEX-PN Examination through March 31, 2026.
3. Can You Get the Pearson Vue Good Pop Up and Still Fail? Unfortunately, the only way to know for sure if you have passed the NCLEX is to wait for your official results. Although it does not always happen, the Pearson Vue trick can give you a good pop-up even if you failed the NCLEX exam.
NCLEX-RN test-takers are required to answer at least 75 questions. A minimum of 85 questions must be completed by those taking the NCLEX-PN. The number of questions a test-taker might have to answer varies because of the way the test is designed.
You can successfully answer the first 59 questions, but if you don't get to question 60, you will automatically fail the exam. Another method to fail the exam is to not answer enough questions properly within the allocated time or to not answer enough questions correctly out of the maximum of 145 or 265 questions.
There are three pass/fail rules for the NCLEX examinations: the Run-Out-Of-Time rule, the Maximum-Length Exam Rule and the 95-Percent Confidence Interval Rule.
The maximum is 145 though. So if the computer shuts off at 145, that meant you still had a chance at 144. It shuts off when you no longer have a chance. Therefore if it shuts off at the maximum, you were close.
The best strategy is to review every day and practice NCLEX-style questions again and again. It is far better to set aside some time every day over weeks than to try and cram everything into a few study sessions right before you retest. Set a schedule and stick to it.
Carefully read the entire question. Don't rush through it or stop halfway through because you assume that you know what's being asked. Reword the stem to make it easier to understand, and answer the question. Look for hints or key words, such as most, all, first, best, primary, initial, always, and never.
We recommend that you complete about 2,800 practice questions before your exam. If you are giving yourself a month to study, that means that you would be doing about 100 NCLEX practice questions per day.
The hiring panel may ask you about the six core values to assess your knowledge. The 6 Cs – care, compassion, courage, communication, commitment, competence - are a central part of 'Compassion in Practice'. They'll want to know what you think about the 6 Cs and understand how you can effectively put them into practice.
Another way of solving a confusing SATA question is by eliminating options by the true or false filter. Consider each option with reference to the question and ask yourself if the option is true/false or yes/ no for that question. If the option is false, you can eliminate that option.
Does NCLEX-RN Get Harder with Every Retake After Failing? Some candidates mistakenly believe that the NCLEX is harder each time. Questions become more challenging with each correct answer you provide on the NCLEX. However, subsequent tests are not easier or more difficult than previous exams.
To pass the NCLEX RN or PN, test takers must correctly answer at least 85 questions (the minimum amount). Unfortunately, that means you can also fail the exam within those 85 questions or items.
Does 145 questions on NCLEX mean you failed? No, if you answer all 145 questions on the NCLEX, that does not mean you fail. In fact, if you answered 145 questions and each question was progressively more challenging, then that is a good sign that you passed.
1. New Hampshire. New Hampshire boasts the highest NCLEX pass rate average in the U.S., over 14% higher than the national average. In 2022, five of the state's eight bachelor of science in nursing (BSN) programs reported first-time pass rates above 90%, including a 100% rate for Plymouth State University.
A candidate that asks, how many questions do you need to pass NCLEX, will not receive a definite answer. Candidates must answer at least 75 questions in the five available hours or fail the test. The maximum number of questions in both exams is 145. Therefore, test-takers typically answer between 75 and 145.
The NCLEX-RN® is composed of primarily multiple-choice, four-option, text-based questions written at the application/analysis level of difficulty. These questions may include charts, tables, or graphic images. There are three components of an NCLEX-RN® exam multiple-choice question.
How many questions are on the NCLEX? A test-taker will see a minimum of 60 questions and a maximum of 145 questions on the NCLEX-RN and PN. Each of the tests will also include 15 experimental questions that do not count in scoring.
Introduction: My name is Saturnina Altenwerth DVM, I am a witty, perfect, combative, beautiful, determined, fancy, determined person who loves writing and wants to share my knowledge and understanding with you.
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By Winona Suzanne Ball, RN, MHS
