NCLEX

What is it? How should I study?

How do I pass??

What is the NCLEX?

National Council Licensure

Examination
Administered by the boards of nursing
of all 50 states
Mandate to protect the public from
unsafe and ineffective nursing care

Why must you take the

NCLEX?

Each state requires you to pass the

NCLEX to get a license
Once you get a license, you will get a
title of Registered Nurse (RN)

CAT Computer Adaptive

Testing

Each test is assembled interactively based on the

accuracy of the candidates response to the
questions.
First question will be relatively easy, below the level
of minimum competency.
If you answer that question correctly, the computer
selects a slightly more difficult question.
If you answer it incorrectly, the computer selects a
slightly easier question
By continuing to do this, the computer can calculate
your level of competence.

Taking the Exam

No time limit for each individual question

Maximum of 6 hours to complete the exam.
Optional 10 min break after the first 2
hours. Optional break after additional 90
min of testing
Minimum 75 questions, maximum 265
questions
15 experimental questions,
indistinguishable, do not count for or
against you

Test ends when:

You have demonstrated competency and

answered the minimum number of
questions (75)
You have demonstrated a lack of minimum
competency and answered the minimum
number of questions (75)
You have answered the maximum number
of questions (265)
You have used the maximum time allowed
(six hours)

Length of test

Try not to be concerned with the

length of the test
Plan on testing for 6 hours and seeing
265 questions
No warm-up time so it is important to
be ready to answer every question
from the beginning
Concentration is key!!!

Content
Management of Care

13-19%

Safety and Infection Control

8-14%

Health Promotion and Maintenance

6-12%

Psychosocial Integrity

6-12%

Basic Care and Comfort

6-12%

Pharmacological and Parenteral Therapies

13-19%

Reduction of Risk Potential

13-19%

Physiological Adaptation

11-17%

Management of Care 13-19%

A client arrives at the emergency department

complaining of acute right lower quadrant
abdominal pain. Laboratory tests are performed
and the nurse notes that the clients white blood
cell (WBC) count is elevated. The nurse reviews
the physicians orders and contacts the physician
to question which order, if noted, in the clients
record?

1.
2.
3.
4.

Maintain an NPO status

Apply a cold pack to the abdomen
Administer 30 mL of Milk of Magnesia (MOM)
Initiate an intravenous (IV) line for the administration of
IV fluids

Safety and Infection

Control 8-14%

A hospitalized client is diagnosed with

urethritis caused by a chlamydial infection.
The nurse instructs the nursing assistant
about which measure to prevent
contracting the infection during care?
1.
2.
3.
4.

Contact isolation
Enteric precautions
Standard precautions
Use of gloves and mask

Health Promotion and

Maintenance 6-12%

A 7-year-old child is hospitalized with a

fracture of the femur and is placed in
traction. In meeting the developmental
needs of the child, the nurse selects which
of the following play activities for the
child?

1.
2.
3.
4.

A
A
A
A

board game
large puzzle
finger painting set
coloring book with crayons

The school age child becomes occupied with activities such as collections,
drawing, construction, dolls, pets, guessing games, board games, riddles, etc.
Option 2 is appropriate for a toddler. 3 and 4 are for preschooler.

Psychosocial Integrity 6-12%

A client with ovarian cancer says to the

nurse, If I can just live long enough to
attend my daughters graduation, Ill be
ready to die. The nurse determines that
the client is experiencing which phase of
coping?
1.
2.
3.
4.

Isolation
Bargaining
Depression
Acceptance

Basic Care and Comfort 6-12%

A nurse provides instructions to a client about the

use of a cane and watches as the client uses it.
Which observation by the nurse indicates the
need to provide additional instructions to the
client?
1.
2.
3.
4.

The client holds the cane on the strong side.

The client holds the cane about 6 inches to the side of
the foot.
The client flexes the elbow at a 15- to 30-degree angle
when holding the cane in place.
The client moves the cane and the stronger leg forward
first and then moves the weaker leg forward.

Pharmacological and Parenteral

Therapies 13-19%

A nurse caring for a client with hypertension

receiving torsemide (Demadex) 5 mg orally daily.
Which laboratory finding indicates to the nurse
that the client might be experiencing an adverse
reaction related to the medication?
1.
2.
3.
4.

A
A
A
A

chloride level of 98 mEq/L

sodium level of 135 mEq/L
potassium level of 3.1 mEq/L
blood urea nitrogen level (BUN) of 15 mg/dL

Torsemide (Demadex) is a loop diuretic. It can produce water loss

and electrolyte depletion. Normal K+ level 3.5-5.0 mEq/L.

Reduction of Risk Potential 13-19%

A magnetic resonance imaging (MRI) procedure

is prescribed for a client with a suspected brain
tumor. The nurse implements which action to
prepare the client for this test?
1.
2.
3.
4.

Keeps the client NPO for 6 hours prior to the test

Shaves the groin for insertion of a femoral catheter
Removes all metal-containing objects from the client
Instructs the client in inhalation techniques for the
administration of the radioisotope

Physiological Adaptation 11-17%

A nurse reviews the blood gas results of a

client with pneumonia and determines that
the client is experiencing respiratory
acidosis. Which of the following validates
the nurses findings?
1.
2.
3.
4.

pH
pH
pH
pH

7.45,
7.35,
7.25,
7.50,

PCO2
PCO2
PCO2
PCO2

52
40
50
30

mm
mm
mm
mm

Hg
Hg
Hg
Hg

The Nursing Process

Assessment
Analysis
Nursing Diagnosis
Planning
Implementation
Evaluation

Critical Thinking

Levels of Questions
in Nursing Tests
Blooms Taxonomy

Analysis

Application

Understanding

Recall/Recognition

The following is an example of a

knowledge based question you might
have seen in school. This question is at
the knowledge level.

Which of the following is a

complication that occurs during the
first 24 hours after a percutaneous
liver biopsy?
1.
2.
3.
4.

Nausea and vomiting

Constipation
Hemorrhage
Pain at the biopsy site

Questions at the comprehension level require

you to understand the meaning of the material.
Lets look at the same question written at the
comprehension level.

The nurse understands that hemorrhage is

a complication of a liver biopsy because:
1. There are several large blood vessels near the
liver
2. The liver cells are bathed with a mixture of
venous and arterial blood
3. The test is performed on clients with elevated
enzymes
4. The procedure requires a large piece of tissue
to be removed

Minimum competency NCLEX questions are

written at the application or analysis level. Your
ability to solve problems is not tested with
recall/recognition or comprehension level
questions.

Which of the following symptoms, if

observed by the nurse during the first 24
hours after a percutaneous liver biopsy,
would indicate a complication from a
procedure?
1. Anorexia, nausea, and vomiting
2. Abdominal distention and discomfort
3. Pulse 112, blood pressure 100/60, respirations
20
4. Pain at the biopsy site

The question is: What is a complication

of a liver biopsy?

In order to begin to analyze this

question, you must know that
hemorrhage is the major complication.
But its not listed as an answer

So lets look at the choices

Anorexia, nausea, and vomiting. Does this indicate that

the client is hemorrhaging? No, these are not
symptoms of hemorrhage.
Abdominal distention and discomfort. Does this indicate
that the client is hemorrhaging? Perhaps. Abdominal
distention could indicate abdominal bleeding.
Pulse 112, blood pressure 100/60, respirations 20. Does
this indicate the client is hemorrhaging? Yes. An
increased pulse, decreased BP, and increased
respirations indicate shock. Shock is the result of
hemorrhage
Pain at the biopsy site. Does this indicate the client is
hemorrhaging? No, pain is expected with this
procedure.

How about an analysis level question

The nurse is caring for a 56-year old man

receiving Haldol 2 mg PO BID. The nurse assists
the client to choose which of the following
menus?
1.
2.
3.
4.

3 oz. roast beef, baked potato, salad with dressing, dill

pickle, baked apple pie, and milk
3 oz. baked chicken, green peas, steamed rice, 1 slice of
bread, banana, and milk
Cheeseburger on a bun, french fries with catsup,
chocolate chip cookies, apple, milk
3 oz. baked fish, 1 slice of bread, broccoli, ice cream,
and pineapple drink taken - 1 hour after the meal

Dont panic!!!

What type of diet do you chose for a

patient taking Haldol?
Haldol is antipsychotic med
There are no diet restrictions for
Haldol
This question is really a diet question
Which of the choices is the most
balanced regular diet??

Answers
1.
2.

3.
4.

3 oz. roast beef, baked potato, salad with dressing, dill pickle,
baked apple pie, and milk. Is this a balanced diet? Yes, its possible
3 oz. baked chicken, green peas, steamed rice, 1 slice of bread,
banana, and milk. Yes, it is also a good answer because it contains
food from each of the food groups.
Cheeseburger on a bun, french fries with catsucp, chocolate chip
cookies, apple, milk. No, this diet is high in fat and does not
contain food groups. Eliminate.
3 oz. baked fish, 1 slice of bread, broccoli, ice cream, and
pineapple drink taken - 1 hour after the meal. The choice isnt
bad, but why would the intake of fluids be delayed? Eliminate

Which is the better answer? 1 or 2? Dill pickles are

high in sodium, so the correct answer is 2.

Strategies that DONT

work!

Cramming in hundreds of facts about disease

process and nursing care.
Recognizing and recalling facts rather than
understanding the pathophysiology and the needs
of a client with an illness.
Knowing who wrote the question and what is
important to that instructor.
Selecting the response that is a different length
compared to the other choices.
Selecting the answer choice that is grammatically
correct.
When in doubt, choosing C.

To be successful on the
NCLEX, you must

Read the question

Decide what the question is asking
Evaluate the answer choices
Select the correct answer