How does the NCLEX Examination work?

Every nursing student has the same questions in regards to the NCLEX examination.

I thought it may be helpful to take a look at some of these questions to help you be ready for what is coming.

Where do I start with the NCLEX?

• Registering: obvious first step is signing up for your NCLEX exam, typically near the end of your senior year of nursing school:
1.Apply to state board through website and pay fee
2.Authorization to Test (ATT) received about 30 days after state receives school verification of degree
3.You schedule a date within 30 days of ATT or you risk expiration of your date

What about how the NCLEX is arranged and how it is graded? What does it take to pass?

CAT: Computer Adaptive Test (i.e. they keep asking you questions from subjects you get wrong, and leave ones you got right)
•75-265 questions possible (15 don’t count)
–I personally know people that have passed and failed at 75, 135, and 265 so don’t despair
•Max time allowed is 6 hours
•Check Results in 48 hours on state website by doing a search for your name as a REGISTERED NURSE!!!

Your NCLEX exam is graded in an adaptive form as well. Check out the following picture while reading this description. You start off with easy questions and are at the midline of the yellow block. If you get an easier question right, you get a point in the positive direction (towards the green), while if you get an easy one wrong you get 5 points in the negative direction (towards the red). If you get the easier one right, you get a harder one that will give you 2 points in the positive direction, and if wrong, 4 points in the negative direction. As you continue to get questions right, you move to harder and harder ones, where eventually you will get 5 points in the positive direction for a correct answer, and only 1 point in the negative direction for a wrong one. For incorrect questions you also move to easier and easier questions, which as stated, are worth less for correct and more for incorrect. At 75 questions the computer does an analysis of your trend line and if you are in the green at this point you are done and have passed your NCLEX exam, usually with greater than 58% correct. If you are in the red at this point you are done and have failed your NCLEX, usually with less than 42% correct. If you are located in the yellow, your NCLEX examination continues until the next random trend checkpoint.

What subjects are covered on the NCLEX?

Question Possibilities (Out of any 12 nclex questions)
•Safe Effective Care:
–Management: (2/12) Med Admin, Dx/Tx procedures
–Safety/Infection Control: (1/12) Precautions (airborne, etc)
•Health Promotion/Maintenance: (1/12) Development, Risk avoidance, recognize alterations in health
•Psychosocial Integrity: (1/12) Stress Coping, Problem solving
•Physiologic Integrity
–Basic Care/Comfort: (1/12) ADLS, Teaching (ie crutches)
–Pharmacology: (2/12) Drug indications, routes, admin, S/E
–Risk Reduction: (2/12) Prevent drug, tx, dz complications
–Physiologic Adaptation: (2/12) Disease s/s, lab values

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What types of questions styles are used on the NCLEX? I mean are they all multiple choice?

Question Types
•Multiple Choice
•Fill in the blank
•Multiple Response
•Ordered Response
•Figure/Illustrations

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How do I study to pass the NCLEX examination?

In short...PREPARE EARLY! I would recommend starting to do NCLEX Review questions at least by the start of your senior year. You can do this in conjunction with your classes, where for example, you study NCLEX Review questions on Pharmacology while studying for your Pharmacology class. Here is a schedule that I recommend to my NCLEX Review students:

Success Plan
•Fall: Use NCLEX review book with good summary section in all classes
–While studying, combine class notes with book review (I built a study guide for all tests out of both resources)
–Do all questions pertaining to that section for each test
–If you study in groups, have different books and quiz each other from these
–Try to answer at least 100 NCLEX book questions before each test.
•Total Questions Completed: 1000
•Spring: During Role Synthesis, make a plan to cover all subjects/systems from a new, mostly questions book
–Plan 25/day
–Mark % correct/incorrect for each section
–Total Questions Completed: 2500
•Summer: 60 days from grad to test
–Focus on weakest sections first
–Take at least 5 comprehensive tests (100 ?s)
–Average 25/day for 1500 total
•Total Questions Taken all year: 5000 +

I would be willing to say that your liklihood of passing the NCLEX is in direct relation to how many practice questions you have done. If you can surpass the 5000 question goal, you have a very good chance of being ready for the NCLEX when it comes your way.