NCLEX
What is it? How should I study?
How do I pass??
What is the NCLEX?
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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?
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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
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Each test is assembled interactively based on the
accuracy of the candidate’s 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
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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:
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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
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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%
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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 client’s white blood
cell (WBC) count is elevated. The nurse reviews
the physician’s orders and contacts the physician
to question which order, if noted, in the client’s
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%
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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%
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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%
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A client with ovarian cancer says to the
nurse, “If I can just live long enough to
attend my daughter’s graduation, I’ll 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%
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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%
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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%
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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%
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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 nurse’s 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
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Assessment
Analysis
Nursing Diagnosis
Planning
Implementation
Evaluation
Critical Thinking
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Level’s of Questions
in Nursing Tests –
Bloom’s 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.
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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.
Let’s look at the same question written at the
comprehension level.
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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.
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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?
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In order to begin to analyze this
question, you must know that
hemorrhage is the major complication.
But it’s not listed as an answer
So let’s look at the choices…
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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…
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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 ½ - 1 hour after the meal
Don’t panic!!!
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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, it’s 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 ½ - 1 hour after the meal. The choice isn’t
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 DON’T
work!
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“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…
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Read the question
Decide what the question is asking
Evaluate the answer choices
Select the correct answer