The NCLEX is an in-depth evaluation conducted by the National Council of State Boards of Nursing (NCSBN). It determines if the candidates have the skills and understanding required to provide secure and efficient nursing care at the entry-level. The NCLEX comes in two types: NCLEX-RN for registered nurses and NCLEX-PN for practical/vocational nurses.
To become a registered nurse (RN), you must first complete the particular licensure standards established by the licensing authorities in each jurisdiction administered by the NCSBN. One of these prerequisites is passing the NCLEX-RN, which assesses the competencies required for secure and effective practice as an entry-level RN.
What is the NCLEX Exam? Who takes the test?
What exactly is the NCLEX? The National Council Licensure Examination is abbreviated as NCLEX. It is a standardized test that determines whether or not a test taker is competent enough to become a licensed nurse.
The NCLEX test has two variations, depending on the type of nurse you want to be:
- NCLEX-PN: For practical nurses (LPNs) or vocational nurses (LVNs)
- NCLEX-RN: For registered nurses (RNs)
Both exams test the following topics:
- Safe and Effective Care Environment
- Management of Care – This category comprises information that assesses the nurse’s knowledge and capacity to provide nursing care in order to protect clients, significant others, and healthcare workers.
- Safety and Infection Control – Content in this category assesses the nurse’s capacity to protect clients, families, and healthcare employees from health and environmental threats.
- Health Promotion and Maintenance – This area contains information that assesses the nurse’s capacity to give and direct nursing care to clients, including understanding of expected growth and development, preventing and early diagnosis of health concerns, and methods for achieving optimal health.
- Psychosocial Integrity – This category contains articles pertaining to the advancement and encouragement of the emotional, mental, and social well-being of clients enduring stressful circumstances as well as those suffering from acute or chronic mental illness.
- Physiological Integrity – Items in this category assess the nurse’s capacity to enhance physical health and wellness by providing treatment and support, lowering risk potential, and managing health changes. Physiological Integrity is divided into four subcategories.
- Basic Care and Comfort – are designed to assess the nurse’s capacity to provide comfort and help to the client while undertaking daily activities.
- Pharmacological and Parenteral Therapies – This category contains data designed to assess a nurse’s ability to administer drugs and parenteral therapies (IV therapy, blood administration, and blood products).
- Reduction of Risk Potential – This category contains material designed to assess the nurse’s capacity to prevent complications or health problems associated with the client’s condition or prescribed treatments or procedures.
- Physiological Adaptation – Questions in this area assess the nurse’s capacity to care for clients with acute, chronic, or life-threatening conditions.
Question Types in the NCLEX
Extended Multiple Response
Test takers can select one or more Multiple Response options in Extended Multiple Response item types. Select All That Apply, a set number of items in Multiple Response Select N, or alternatives from various groupings displayed in a table in Multiple Response Grouping, with scoring rules based on the type picked. Extended multiple response forms could include the following:
- Multiple Response Select All That Apply
The item type Multiple Response Select All That Apply enables test takers to select one or more answer options. It employs the +/- Scoring Rule, which states that right data earns points (+1), while inaccurate data earns points (-1). The highest number of points earned is equal to the number of correct answers, and the minimum score is 0, with no negative scores. The item must have at least five alternatives and can have up to ten options, with all ten options being correct.
- Multiple Response Grouping
The Multiple Response Grouping presents alternatives in a table, with a minimum of two and a maximum of five categories. Each grouping has a minimum of two and a maximum of four alternatives, guaranteeing that each grouping has an equal amount of options. Test takers must choose at least one item from each cluster. The item adheres to the +/- Scoring Rule, which means there are no negative scores per grouping. The item’s overall score is calculated by adding the points gained in each grouping. The highest possible score is equal to the number of keys (N).
- Multiple Response Select N
The Multiple Response Select N item type notifies the test-taker of the number of items (N) that can be chosen. The question offers a number of choices, with a minimum of five and a maximum of ten. It employs the 0/1 Scoring Rule, in which each accurate response earns 1 point and each incorrect response earns 0 points.
Multiple-Choice Questions
Much of the NCLEX questions are multiple-choice. This classic text-based question will give you information about the client’s problem, and you can only choose one accurate answer from the four possibilities provided. Multiple-choice questions can feature audio samples, images, exhibits, or charts, among other things.
Example:
A patient is about to undergo bone marrow aspiration and biopsy and expresses fear and anxiety about the procedure. Which of the following is the most effective nursing response?
- Warn the patient to stay very still because the smallest movement will increase her pain.
- Encourage the family to stay in the room for the procedure.
- Stay with the patient and focus on slow, deep breathing for relaxation.
- Delay the procedure to allow the patient to deal with her feelings.
Chart or Exhibit Questions
A chart or exhibit is provided beside a specific issue. You’ll be given three tabs or buttons to click in order to gather all the data needed to answer the question. Choose the best answer from four possibilities.
Example:
The nurse notes the following on the ECG monitor. The nurse would evaluate the cardiac arrhythmia as:
- Atrial flutter
- A sinus rhythm
- Ventricular tachycardia
- Atrial fibrillation
Graphic Option
The four multiple-choice response options in this type are images rather than sentences. Each selection is followed by a circle, which you must click to signify your response.
Audio
To answer a question in an audio question format, you have to pay attention to a sound. For it to play, you must use the provided headset and click on the sound icon. You can listen to the sound as many times as you need. Choose the correct answer from four multiple-choice alternatives.
Video
To answer the following question in the video question format, you must first watch an animation or a video clip. Choose the correct answer from four multiple-choice alternatives.
Select-All-That-Apply
A multiple-response or select all that apply (SATA) inquiry requests you to select all right answer possibilities that pertain to the data requested by the question. Usually, there are more than four possible answers. There is no partial credit for scoring these questions (i.e., selecting only three of the five correct answers), thus you must select all correct answers for the item to be counted as accurate.
Example:
The nurse is teaching the client how to use a metered dose inhaler (MDI) to administer a Corticosteroid drug. Which of the following client actions indicates that he is using the MDI correctly? Select all that apply.
- The inhaler is held upright.
- Head is tilted down while inhaling the medication.
- Client waits 5 minutes between puffs.
- Mouth is rinsed with water following administration.
- Client lies supine for 15 minutes following administration.
Fill-In-The-Blank
The fill-in-the-blank inquiry style is commonly used for medication calculations, IV flow rate calculations, and establishing a client’s intake output. In this question format, you will be asked to conduct a calculation and put your answer in the blank space supplied.
Example
An order reads furosemide (Lasix) 40 mg IV push. You have on hand Lasix 20 mg/2 mL. How should you prepare the correct dose? Fill in the blank.
___________________________ mL
NCLEX can be overwhelming if you think about all the things you need to prepare for. But, if you are going to look at it one by one, then you will be able to understand it as fast as you can. To understand how it works, it is better to take things one step at a time. You will be able to grasp the data and confidently say that you understand it.
Now that you already have some ideas of what the test will be like, let’s know more about Mnemonics and how it works. As a nurse, you have to remember a lot of things. This will help you make sure you remember the exact words you need to memorize.
Study Tip for NCLEX: Mnemonics
A mnemonic (“nuh-MAH-nik”) is a tool for remembering facts or vast volumes of data. It is usually a single brief sentence or word. It is also known as a “memory aid,” and it is a method of improving and assisting memory. Remember when you were learning to sing the “A-B-C” song? That is a mnemonic for remembering alphabet letters in the correct order. Mnemonics are not intended to be exhaustive. They serve as fast reminders to jog your memory. It is your responsibility to learn the facts and logic for everything for which you are responsible.
You have 4 topics that need to be covered for NCLEX: Safe and Effective Care Environment, Health Promotion and Maintenance, Psychosocial Integrity, and Physiological Integrity.
Safe and Effective Care Environment
Steps in the Nursing Process: ADPIE (A Delicious PIE)
A = Assessment
D = Diagnosis (Sometimes called “Analysis”)
P = Planning
I = Implementation
E = Evaluation
RN Assignments & Delegation: Do not delegate what you can EAT
E = Evaluate
A = Assess
T = Teach
Disaster Preparation/Emergency Trauma Assessment: ABCDEFGHI
A = Airway
B = Breathing
C = Circulation
D = Disability
E = Expose/Examine
F = Full set of vital signs
G = Give comfort measures
H = Head-to-to assessment
I = Inspect posterior
Contact Precautions: MRS WEE
M = Multidrug resistant organism
R = Respiratory infection
S = Skin infection
W = Wound infection
E = Enteric (Clostridium difficile)
E = Eye infection (conjunctivitis)
Droplet Precautions: SPIDERMAN
S = Sepsis/Scarlet fever/Streptococcal pharyngitis
P = Pneumonia/Pertussis/Parovirus B19
I = Influenza
D = Diphtheria
E = Epiglottitis
R = Rubella
M = Mumps/Meningitis/Meningeal pneumonia/Mycoplasma
An = Adenovirus
Health Promotion and Maintenance
Basics of Prenatal Care: ABCDEF
A = Amniotic fluid
B = Bleeding
C = Contractions
D = Dysuria
E = Edema
F = Fetal movement
APGAR Score: Method for quickly evaluating a neonate at 1 and 5 minutes
A = Appearance
P = Pulse
G = Grimace
A = Activity
R = Respiration
Evaluation of Irregular Moles for Early Detection: ABCDE
A = Asymmetry: Is the mole irregular in shape?
B = Border: Is the border irregular, notched, or poorly defined?
C = Color: Does the color of the mole vary? (Shades of brown, black, red, white, or blue?)
D = Diameter: Is the diameter more than 6 mm? (1/4 inch)
E = Elevation or Evolution: Is it raised or has it changed in the past 6 months?
Warning Signs of Cancer: CAUTION
C = Change in bladder or bowels
A = A sore that won’t heal
U = Unusual bleeding and/or discharge
T = Thickening or lumping tissue
I = Indigestion or trouble swallowing
O = Obvious change in the size of a mole or wart
N = Nagging cough and/or hoarseness
Psychosocial Integrity
Depression Signs and Symptoms: AWESOME
A = Affect flat
W = Weight change (gain or loss)
E = Energy, loss of
S = Sadness/Suicidal thoughts/Sleep changes/Social withdrawal
O = Others (guilt, loss of pleasure, hopelessness)
M = Memory loss
E = Emotional blunting
Five Interventions for Psychiatric Patients: Setting Sun Equals Moon Light
S = Safety
S = Setting limits
E = Establish trusting relationships
M = Medications
L = Least restrictive environment or methods
Primary Symptoms of a Manic Attack: DIG FAST
D = Distractibility
I = Indiscretion
G = Grandiosity
F = Flight of Ideas
A = Activity Increase
S = Sleep Deficit
T = Talkativeness
Kubler-Ross stages of dying: Death Always Brings Great Acceptance
D = Denial
A = Anger
B = Bargaining
G = Grieving/Depression
A = Acceptance
Physiological Integrity
Activities of Daily Living (ADLs): BATTED
B = Bathing
A = Ambulation
T = Toileting
T = Transfers
E = Eating
D = Dressing
Prevention/Management of Pressure Sores: SKIN
S = Surfaces should be smooth
K = Keep moving/repositioning
I = Incontinence management
N = Nutrition
Fat-Soluble Vitamins: All Dogs Eat Kibble
Vitamin A
Vitamin D
Vitamin E
Vitamin K
Order of Walking with a Cane: COAL
C = Cane
O = Opposite
A = Affected
L = Leg
Going Up and Down Stairs with a Cane:
“Up with the Good, Down with the Bad”
Order of Walking with a Walker: Wandering Wilma Always Late
W = Walker
W = With
A = Affected
L = Leg
These letters and words can be a lot, but these will surely help you through your preparation for the examination. There are a lot of things you can do to prepare for the examination, although remember that you might need help from now on. AuRNPathway will definitely help you pass this examination. Not only will we help you with the preparation, but we will also provide quality lessons, hands-on practice, and endless support until you reach your goal.
References:
What is the NCLEX exam? Everything you need to know.