NCLEX

NCLEXNCLEX

What is it? How should I What is it? How should I study? How do I pass??study? How do I pass??

What is the NCLEX?What is the NCLEX?

National Council Licensure National Council Licensure ExaminationExamination

Administered by the boards of Administered by the boards of nursing of all 50 statesnursing of all 50 states

Mandate to protect the public Mandate to protect the public from unsafe and ineffective from unsafe and ineffective nursing carenursing care

Why must you take the Why must you take the NCLEX?NCLEX? Each state requires you to pass Each state requires you to pass

the NCLEX to get a licensethe NCLEX to get a license Once you get a license, you will Once you get a license, you will

get a title of Registered Nurse get a title of Registered Nurse (RN)(RN)

CAT – Computer CAT – Computer Adaptive TestingAdaptive Testing Each test is assembled interactively based on Each test is assembled interactively based on

the accuracy of the candidate’s response to the accuracy of the candidate’s response to the questions.the questions.

First question will be relatively easy, below the First question will be relatively easy, below the level of minimum competency.level of minimum competency.

If you answer that question correctly, the If you answer that question correctly, the computer selects a slightly more difficult computer selects a slightly more difficult question.question.

If you answer it incorrectly, the computer If you answer it incorrectly, the computer selects a slightly easier questionselects a slightly easier question

By continuing to do this, the computer can By continuing to do this, the computer can calculate your level of competence.calculate your level of competence.

Taking the ExamTaking the Exam

No time limit for each individual No time limit for each individual questionquestion

Maximum of 6 hours to complete the Maximum of 6 hours to complete the exam. Optional 10 min break after the exam. Optional 10 min break after the first 2 hours. Optional break after first 2 hours. Optional break after additional 90 min of testingadditional 90 min of testing

Minimum 75 questions, maximum 265 Minimum 75 questions, maximum 265 questionsquestions

15 experimental questions, 15 experimental questions, indistinguishable, do not count for or indistinguishable, do not count for or against youagainst you

Test ends when:Test ends when:

You have demonstrated competency You have demonstrated competency and answered the minimum number of and answered the minimum number of questions (75)questions (75)

You have demonstrated a lack of You have demonstrated a lack of minimum competency and answered minimum competency and answered the minimum number of questions (75)the minimum number of questions (75)

You have answered the maximum You have answered the maximum number of questions (265)number of questions (265)

You have used the maximum time You have used the maximum time allowed (six hours)allowed (six hours)

Length of testLength of test

Try not to be concerned with the Try not to be concerned with the length of the testlength of the test

Plan on testing for 6 hours and Plan on testing for 6 hours and seeing 265 questionsseeing 265 questions

No warm-up time so it is important No warm-up time so it is important to be ready to answer every to be ready to answer every question from the beginningquestion from the beginning

Concentration is key!!!Concentration is key!!!

ContentContent

Management of CareManagement of Care 13-19%13-19%

Safety and Infection ControlSafety and Infection Control 8-14%8-14%

Health Promotion and MaintenanceHealth Promotion and Maintenance 6-12%6-12%

Psychosocial IntegrityPsychosocial Integrity 6-12%6-12%

Basic Care and ComfortBasic Care and Comfort 6-12%6-12%

Pharmacological and Parenteral Pharmacological and Parenteral TherapiesTherapies

13-19%13-19%

Reduction of Risk PotentialReduction of Risk Potential 13-19%13-19%

Physiological AdaptationPhysiological Adaptation 11-17%11-17%

Management of Care 13-Management of Care 13-19%19% A client arrives at the emergency A client arrives at the emergency

department complaining of acute right department complaining of acute right lower quadrant abdominal pain. Laboratory lower quadrant abdominal pain. Laboratory tests are performed and the nurse notes tests are performed and the nurse notes that the client’s white blood cell (WBC) that the client’s white blood cell (WBC) count is elevated. The nurse reviews the count is elevated. The nurse reviews the physician’s orders and contacts the physician’s orders and contacts the physician to question which order, if noted, physician to question which order, if noted, in the client’s record?in the client’s record?1.1. Maintain an NPO statusMaintain an NPO status2.2. Apply a cold pack to the abdomenApply a cold pack to the abdomen3.3. Administer 30 mL of Milk of Magnesia (MOM)Administer 30 mL of Milk of Magnesia (MOM)4.4. Initiate an intravenous (IV) line for the Initiate an intravenous (IV) line for the

administration of IV fluidsadministration of IV fluids

Safety and Infection Safety and Infection Control 8-14%Control 8-14% A hospitalized client is diagnosed with A hospitalized client is diagnosed with

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

1.1. Contact isolationContact isolation

2.2. Enteric precautionsEnteric precautions

3.3. Standard precautionsStandard precautions

4.4. Use of gloves and maskUse of gloves and mask

Health Promotion and Health Promotion and Maintenance 6-12%Maintenance 6-12% A 7-year-old child is hospitalized with A 7-year-old child is hospitalized with

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

1.1. A board gameA board game2.2. A large puzzleA large puzzle3.3. A finger painting setA finger painting set4.4. A coloring book with crayonsA 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-Psychosocial Integrity 6-12%12% A client with ovarian cancer says to A client with ovarian cancer says to

the nurse, “If I can just live long the nurse, “If I can just live long enough to attend my daughter’s enough to attend my daughter’s graduation, I’ll be ready to die.” The graduation, I’ll be ready to die.” The nurse determines that the client is nurse determines that the client is experiencing which phase of coping? experiencing which phase of coping?

1.1. IsolationIsolation2.2. BargainingBargaining3.3. DepressionDepression4.4. AcceptanceAcceptance

Basic Care and Comfort 6-Basic Care and Comfort 6-12%12% A nurse provides instructions to a client A nurse provides instructions to a client

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

1.1. The client holds the cane on the strong side.The client holds the cane on the strong side.2.2. The client holds the cane about 6 inches to the The client holds the cane about 6 inches to the

side of the foot.side of the foot.3.3. The client flexes the elbow at a 15- to 30-degree The client flexes the elbow at a 15- to 30-degree

angle when holding the cane in place.angle when holding the cane in place.4.4. The client moves the cane and the stronger leg The client moves the cane and the stronger leg

forward first and then moves the weaker leg forward first and then moves the weaker leg forward.forward.

Pharmacological and Pharmacological and Parenteral Therapies 13-Parenteral Therapies 13-19%19% A nurse caring for a client with A nurse caring for a client with

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

1.1. A chloride level of 98 mEq/LA chloride level of 98 mEq/L2.2. A sodium level of 135 mEq/LA sodium level of 135 mEq/L3.3. A potassium level of 3.1 mEq/LA potassium level of 3.1 mEq/L4.4. A blood urea nitrogen level (BUN) of 15 mg/dLA 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-Reduction of Risk Potential 13-19%19%

A magnetic resonance imaging (MRI) A magnetic resonance imaging (MRI) procedure is prescribed for a client with a procedure is prescribed for a client with a suspected brain tumor. The nurse implements suspected brain tumor. The nurse implements which action to prepare the client for this test?which action to prepare the client for this test?

1.1. Keeps the client NPO for 6 hours prior to the testKeeps the client NPO for 6 hours prior to the test

2.2. Shaves the groin for insertion of a femoral catheterShaves the groin for insertion of a femoral catheter

3.3. Removes all metal-containing objects from the Removes all metal-containing objects from the clientclient

4.4. Instructs the client in inhalation techniques for the Instructs the client in inhalation techniques for the administration of the radioisotopeadministration of the radioisotope

Physiological Adaptation 11-Physiological Adaptation 11-17%17%

A nurse reviews the blood gas results A nurse reviews the blood gas results of a client with pneumonia and of a client with pneumonia and determines that the client is determines that the client is experiencing respiratory acidosis. experiencing respiratory acidosis. Which of the following validates the Which of the following validates the nurse’s findings?nurse’s findings?

1.1. pH 7.45, PCO2 52 mm HgpH 7.45, PCO2 52 mm Hg




The Nursing ProcessThe Nursing Process

AssessmentAssessment AnalysisAnalysis Nursing DiagnosisNursing Diagnosis PlanningPlanning ImplementationImplementation EvaluationEvaluation

Critical ThinkingCritical Thinking

Level’s of Level’s of Questions in Questions in Nursing Tests – Nursing Tests – Bloom’s Bloom’s TaxonomyTaxonomy

Analysis

Application

Understanding

Recall/Recognition

The following is an example of a The following is an example of a knowledge based question you knowledge based question you might have seen in school. This might have seen in school. This question is at the knowledge level.question is at the knowledge level.

Which of the following is a Which of the following is a complication that occurs during complication that occurs during the first 24 hours after a the first 24 hours after a percutaneous liver biopsy?percutaneous liver biopsy?

1.1. Nausea and vomitingNausea and vomiting

2.2. ConstipationConstipation

3.3. HemorrhageHemorrhage

4.4. Pain at the biopsy sitePain at the biopsy site

Questions at the comprehension level Questions at the comprehension level require you to understand the meaning of require you to understand the meaning of the material. Let’s look at the same the material. Let’s look at the same question written at the comprehension question written at the comprehension level.level. The nurse understands that The nurse understands that

hemorrhage is a complication of a hemorrhage is a complication of a liver biopsy because:liver biopsy because:

1.1. There are several large blood vessels There are several large blood vessels near the livernear the liver

2.2. The liver cells are bathed with a mixture The liver cells are bathed with a mixture of venous and arterial bloodof venous and arterial blood

3.3. The test is performed on clients with The test is performed on clients with elevated enzymeselevated enzymes

4.4. The procedure requires a large piece of The procedure requires a large piece of tissue to be removedtissue to be removed

Minimum competency NCLEX questions Minimum competency NCLEX questions are written at the application or analysis are written at the application or analysis level. Your ability to solve problems is not level. Your ability to solve problems is not tested with recall/recognition or tested with recall/recognition or comprehension level questions.comprehension level questions. Which of the following symptoms, if Which of the following symptoms, if

observed by the nurse during the observed by the nurse during the first 24 hours after a percutaneous first 24 hours after a percutaneous liver biopsy, would indicate a liver biopsy, would indicate a complication from a procedure?complication from a procedure?

1.1. Anorexia, nausea, and vomitingAnorexia, nausea, and vomiting2.2. Abdominal distention and discomfortAbdominal distention and discomfort3.3. Pulse 112, blood pressure 100/60, Pulse 112, blood pressure 100/60,

respirations 20respirations 204.4. Pain at the biopsy sitePain at the biopsy site

The question is: What is a The question is: What is a complication of a liver biopsy?complication of a liver biopsy?

In order to begin to analyze this In order to begin to analyze this question, you must know that question, you must know that hemorrhage is the major hemorrhage is the major complication.complication.

But it’s not listed as an answerBut it’s not listed as an answer

So let’s look at the choices…So let’s look at the choices…

Anorexia, nausea, and vomiting. Does this Anorexia, nausea, and vomiting. Does this indicate that the client is hemorrhaging? No, indicate that the client is hemorrhaging? No, these are not symptoms of hemorrhage.these are not symptoms of hemorrhage.

Abdominal distention and discomfort. Does this Abdominal distention and discomfort. Does this indicate that the client is hemorrhaging? indicate that the client is hemorrhaging? Perhaps. Abdominal distention could indicate Perhaps. Abdominal distention could indicate abdominal bleeding.abdominal bleeding.

Pulse 112, blood pressure 100/60, respirations Pulse 112, blood pressure 100/60, respirations 20. Does this indicate the client is 20. Does this indicate the client is hemorrhaging? Yes. An increased pulse, hemorrhaging? Yes. An increased pulse, decreased BP, and increased respirations decreased BP, and increased respirations indicate shock. Shock is the result of indicate shock. Shock is the result of hemorrhagehemorrhage

Pain at the biopsy site. Does this indicate the Pain at the biopsy site. Does this indicate the client is hemorrhaging? No, pain is expected client is hemorrhaging? No, pain is expected with this procedure.with this procedure.

How about an analysis level How about an analysis level question…question…

The nurse is caring for a 56-year old man The nurse is caring for a 56-year old man receiving Haldol 2 mg PO BID. The nurse receiving Haldol 2 mg PO BID. The nurse assists the client to choose which of the assists the client to choose which of the following menus?following menus?

1.1. 3 oz. roast beef, baked potato, salad with 3 oz. roast beef, baked potato, salad with dressing, dill pickle, baked apple pie, and milkdressing, dill pickle, baked apple pie, and milk

2.2. 3 oz. baked chicken, green peas, steamed rice, 1 3 oz. baked chicken, green peas, steamed rice, 1 slice of bread, banana, and milkslice of bread, banana, and milk

3.3. Cheeseburger on a bun, french fries with catsup, Cheeseburger on a bun, french fries with catsup, chocolate chip cookies, apple, milkchocolate chip cookies, apple, milk

4.4. 3 oz. baked fish, 1 slice of bread, broccoli, ice 3 oz. baked fish, 1 slice of bread, broccoli, ice cream, and pineapple drink taken ½ - 1 hour cream, and pineapple drink taken ½ - 1 hour after the mealafter the meal

Don’t panic!!!Don’t panic!!!

What type of diet do you chose for What type of diet do you chose for a patient taking Haldol?a patient taking Haldol?

Haldol is antipsychotic medHaldol is antipsychotic med There are no diet restrictions for There are no diet restrictions for

HaldolHaldol This question is really a diet This question is really a diet

questionquestion Which of the choices is the most Which of the choices is the most

balanced regular diet??balanced regular diet??

AnswersAnswers

1.1. 3 oz. roast beef, baked potato, salad with dressing, dill 3 oz. roast beef, baked potato, salad with dressing, dill pickle, baked apple pie, and milk. Is this a balanced diet? pickle, baked apple pie, and milk. Is this a balanced diet? Yes, it’s possibleYes, it’s possible

2.2. 3 oz. baked chicken, green peas, steamed rice, 1 slice of 3 oz. baked chicken, green peas, steamed rice, 1 slice of bread, banana, and milk. Yes, it is also a good answer bread, banana, and milk. Yes, it is also a good answer because it contains food from each of the food groups.because it contains food from each of the food groups.

3.3. Cheeseburger on a bun, french fries with catsucp, Cheeseburger on a bun, french fries with catsucp, chocolate chip cookies, apple, milk. No, this diet is high in chocolate chip cookies, apple, milk. No, this diet is high in fat and does not contain food groups. Eliminate.fat and does not contain food groups. Eliminate.

4.4. 3 oz. baked fish, 1 slice of bread, broccoli, ice cream, and 3 oz. baked fish, 1 slice of bread, broccoli, ice cream, and pineapple drink taken ½ - 1 hour after the meal. The pineapple drink taken ½ - 1 hour after the meal. The choice isn’t bad, but why would the intake of fluids be choice isn’t bad, but why would the intake of fluids be delayed? Eliminatedelayed? Eliminate

Which is the better answer? 1 or 2? Dill pickles are high in sodium, so the correct

answer is 2.

Strategies that Strategies that DON’TDON’T work!work! ““Cramming” in hundreds of facts about Cramming” in hundreds of facts about

disease process and nursing care.disease process and nursing care. Recognizing and recalling facts rather than Recognizing and recalling facts rather than

understanding the pathophysiology and the understanding the pathophysiology and the needs of a client with an illness.needs of a client with an illness.

Knowing who wrote the question and what is Knowing who wrote the question and what is important to that instructor.important to that instructor.

Selecting the response that is a different Selecting the response that is a different length compared to the other choices.length compared to the other choices.

Selecting the answer choice that is Selecting the answer choice that is grammatically correct.grammatically correct.

When in doubt, choosing C.When in doubt, choosing C.

To be successful on To be successful on the NCLEX, you must…the NCLEX, you must… Read the questionRead the question Decide what the question is Decide what the question is

askingasking Evaluate the answer choicesEvaluate the answer choices Select the correct answerSelect the correct answer

NCLEX

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