Preparing for the NCLEX

Preparing for the NCLEX-RN Examination

Whether or not you have taken the National Council Licensure Examination (NCLEX-RN), you know that the ability to pursue your career in nursing depends on passing the test. You have learned what you need to know to pass the exam – now you just have to follow through and complete the process!

Every nurse who has ever taken the NCLEX has gone into the exam fearing failure. Although there are those who fail the exam when they first take it, the National Council of State Boards of Nursing (NCSBN) reports that the pass rate for the exam is up to 80% of all applicants. If this is the first time you will take the NCLEX, your chance of passing is even higher. One of the best ways to prepare for the NCLEX is to practice using questions that mimic the content of the exam. Use the tips below to prepare for the NCLEX-RN exam.

Tips for Passing the NCLEX Exam

  • First, it is important that you understand what will be on the test so that you can study for the exam based on the content. There is a very standard NCLEX-RN test plan that is divided into four client needs categories including:
    1. Safe and Effective Care Environment
      1. Management of Care (17 – 23% of the test)
      2. Safety and Infection Control (9 – 15% of the test)
    2. Health Promotion and Maintenance (6 – 12% of the test)
    3. Psychosocial Integrity (6 – 12% of the test)
    4. Physiological Integrity
      1. Basic Care and Comfort (6 – 12% of the test)
      2. Pharmacological and Parenteral Therapies (12 – 18% of the test)
      3. Reduction of Risk Potential (9 – 15% of the test)
      4. Physiological Adaptation (11 – 17% of the test)
  • Know your areas of weakness within the four categories and study those areas. If you don’t know your weak areas, try any of the practice NCLEX-RN exams and use those results to study.
  • Know the types of questions you are likely to encounter on the NCLEX. The types of questions you might encounter are:
    • Of course, most of the questions will be basic multiple choice questions with a stem and four possible choices with only one choice being the BEST response.
    • Multiple response – Similar to a multiple choice, in this type of question you must select ALL of the correct responses.
    • Charts/ graphs – This type of question is similar to the multiple choice but you must use the information in the chart to select the correct response.
    • Drug questions may include calculations that are required to select the correct response. Be sure to review drug calculations!
    • You may see a type of question called an “ordered response”. In this question, all of the responses are correct and you must put the responses in the correct order.
    • A graphic test item is similar to a multiple choice question EXCEPT that all of the response choices are pictures. In this type of item, you will select the picture that is the BEST response.
  • Be sure to remember that you should use the nursing process as you read the questions. The steps of the nursing process will be included in many questions in one form or another:
    • Assess the needs of the patient.
    • Develop a nursing diagnosis based on those needs.
    • Develop the plan of care with the patient and family.
    • Implement the plan of care.
    • Evaluate and revise the plan of care based on the evaluation.
  • Review Maslow’s Hierarchy of Needs and use that pyramid to help you prioritize the care of the patient in the question. Remember that this hierarchy assumes that you should address the most basic need before you move to “higher” needs. Physiological needs must always be addressed before safety, love/ belonging, esteem and self- actualization needs.

  • The NCLEX exam is a test of entry-level knowledge necessary to be a nurse. Therefore, it is important not to look for hidden meaning in the questions. The questions will be testing your basic knowledge OR your ability to use critical thinking skills. Read the questions carefully but don’t overthink them.
  • Look for the trigger words that may help you exclude certain responses. A response that has “always” or “never” in the response is probably incorrect. Be careful to look for the word “not” in the stem. This should be a clue to you to look for the incorrect answer.
  • Exclude the responses that you know are wrong. If you can exclude even one of the responses, you are much more likely to get the question correct.
  • More specific information about the test can be found on the National Council of State Boards of Nursing (NCSBN) website at .

The Day of the NCLEX-RN Examination

When you register for the exam, you will select a testing center in your area. On the day of the test, you should arrive early at the testing center with your photo identification and entry ticket. Arriving early will allow you to catch your breath and mentally prepare yourself for the exam. Each computerized exam will be different, but all test takers will be required to answer at least 75 questions. The maximum number of questions on the test is 265. Remember that you will have a maximum of 6 hours to answer the questions and review your answers, so be sure you manage your time in case you are required to answer the maximum number of questions.

Make your best attempt to answer each question, but if you get stuck on a question, SKIP IT and move on to the next question. If you have time at the end of the exam, go back and review the questions you might have skipped.

When you finish the exam, relax and wait for your passing scores! If you don’t pass on your first attempt, use that try as a learning experience. Next time you will have a better idea of how you should prepare for the exam.