Components of the NCLEX-RN Test Plan 2019-2023

NCSBN defines five processes that are essential to nursing and are therefore incorporated throughout the Client
Needs categories. Those categories and subcategories are identified as:
• Nursing Process: providing client care using a scientific clinical reasoning approach.
• Caring: Use of mutual trust and respect to meet client needs with compassion and support.
• Communication and Documentation: Reciprocal communication among the nurse, client, client’s
significant others, and interprofessional members of the healthcare team. Documentation of information
related to client care that validates accountability.
• Teaching and Learning: Promoting health by facilitating client’s acquisition knowledge.
• Culture and Spirituality: Recognizing and considering the distinctive preferences for care identifies by the
client that are applicable to standards of care.

Client needs, including percentage of items from each category/subcategory

Safe and Effective Care Environment
• Management of Care 17% - 23%.
• Safety and Infection Control 9% - 15%.
Health Promotion and Maintenance 6% - 12%.
Psychosocial Integrity 6% - 12%.
Physiological Integrity 6% - 12%
• Basic Care and Comfort 6% - 12% (caring interventions including cultural and spiritual needs).
• Pharmacological and Parenteral Therapies 12% - 18% (includes alternative medicine and modalities).
• Reduction of Risk Potential 9% - 15% (client safety).
• Physiologic Adaptation 11% - 17%.

Category of Client NCLEX Activities Category of NCLEX Activities

Needs -RN Client Needs -RN
(%) (%)
Safe and 14% - • Client Safety Psychosocial 6% – • Client safety
Effective Care 23% • Advance directives Integrity 12% • Abuse and neglect
Environment • Advocacy Directs nursing • Behavioral interventions
1. Management of • Assignment, delegation, and care, • Chemical and other
Care supervision promoting, and dependencies/substance
Provides and • Case management supporting the use disorders
directs nursing care emotional, • Coping mechanisms
• Client rights
that enhances the mental, and
• Collaboration with • Crisis intervention
care delivery social well-
interdisciplinary team • Cultural
setting to protect being of the
• Concepts of management awareness/cultural
clients and health client
• Confidentiality/information influences on health
care personnel experiencing
security stressful • Religious and spiritual
• Continuity of care events, as well influences on health
• Establishing priorities as clients with • End-of-life care
• Ethical practice acute or • Family dynamics
• Informed consent chronic mental • Grief and loss
• Information technology illness • Sensory and perceptual
• Legal rights and alterations
responsibilities • Stress management
• Performance improvement • Support systems
(QI) • Therapeutic
• Referrals communication
• Therapeutic environment

pg. 1 TN-NCLEX 2020

 Components of the NCLEX-RN Test Plan 2019-2023

Safe and 9% - • Promote patient safety Health 6% - • Aging process

Effective Care 15% • Accident/error/injury Promotion and 12% • Ante/intra/postpartum
Environment prevention Maintenance and newborn care
2. Safety and • Emergency response plan Provides and • Developmental stages and
Infection Control • Ergonomic principles directs nursing transitions
Protecting clients • Handling hazardous and care of the • Health promotion/disease
and healthcare infectious materials client that prevention
personnel from incorporates: • Health screening
• Home safety
health and Knowledge of
• Reporting of • High-risk behaviors
environmental expected
incident/event/irregular • Lifestyle choices
hazards growth and
occurrence/variance • Self-care
development,
• Safe use of equipment Prevention • Techniques of physical
• Security plan and/or early assessments
• Standard detection of • Cultural
precautions/transmission- health awareness/cultural
based precautions/surgical problems, influences on health
asepsis Strategies to • Religious and spiritual
• Use of restraints/safety achieve optimal influences on health
devices health
Physiological 11% - • Assistive devices Physiological 11% - • Alterations in body
Integrity 17% • Elimination Integrity 17% systems
1. Basic Care and • Mobility/immobility 2. Physiological • Fluid and electrolyte
Comfort • Nonpharmacological comfort Adaptation imbalances
Comfort and interventions Manage and • Hemodynamics
assistance in the • Nutrition and oral hydration provide care for • Illness management
performance of clients with • Medical emergencies
• Personal hygiene
activities of daily acute, chronic or
• Rest and sleep-* • Pathophysiology
living life-threatening
• Unexpected response to
physical health
therapy
conditions

Physiological 12% - • Client safety Physiological 9% - • Client safety

Integrity 18% • Adverse Integrity 15% • Changes/abnormalities in
3. Pharmacological effects/contraindications/ 4. Reduction of vital signs
and parenteral side effects/interactions risk potential • Diagnostic tests
therapies • Blood and blood products Reduction in • Laboratory values
Care related to • Alternative medications likelihood that • Potential for alterations in
administration of adverse effects, clients develop body systems
medication and contraindications, side complications or
• Potential for complications
parenteral effects, interactions, adverse health problems
of diagnostic tests/
infusions effects related to
treatments/ procedures
• Central venous access existing
• Potential for complications
devices conditions,
from surgical procedures
treatments or
• Dosage calculation and health alterations
procedures
• Expected actions/outcomes • System-specific
• Medication administration assessments
• Parenteral/intravenous • Therapeutic procedures
therapies • Alternative procedures
• Pharmacological pain (e.g., acupressure)
management
• Total parenteral nutrition

pg. 2 TN-NCLEX 2020