How To Prepare for and Pass the NCLEX-RN Exam

The NCLEX-RN exam is the entry-to-practice exam for all Registered Nurses who wish to practice as a nurse in the United States. While the NCLEX-RN exam may seem like a stressful hurdle to overcome in your journey to become a USRN, it doesn’t have to be! With the right amount of preparation and studying you will be able to pass the exam with ease!

Medliant International Healthcare Staffing offers an extensive NCLEX review to assist you in passing the NCLEX-RN exam on your very first attempt and has helped thousands of nurses successfully immigrate to the US! As an international educated nurse, I wrote and passed the exam in the minimum 75 questions in just over an hour on my very first try using the study tips and helpful hints that I will share with you in this blog post. I’ve also worked as an author publishing NCLEX-RN prep questions for a global publisher and so I am to share all of the strategies that I have learned, to help you!

6 Tips to Prepare for the NCLEX-RN Exam:

Tip #1 PURCHASE YOUR NCLEX STUDY MATERIAL (1 Comprehensive Review Book, 1 Practice Question App/Program)

     a.  Comprehensive Review Books: There are a lot of great study guides available on Amazon or in Eformat (e.g. I personally used the Saunders NCLEX-RN Examination Guide, read it once and passed the NCLEX on my first attempt. The current edition is the 8th edition and I highly recommend it). 

     b.  NCLEX-RN Practice Question App: It is critical to supplement your reading with practice questions that are similar to the NCLEX itself. I purchased the NCLEX RN Mastery App and loved it. I found it to be very identical to the actual NCLEX exam. You can even choose which categories you need to focus on, and it provides you with helpful rationale for the answers of each question).

Tip #2 MAKE A STUDY SCHEDULE

     a.  Plan Your Timeline: I recommend planning for approximately 6-8 weeks of study time depending on how much time that you can allocate each week. I would study 5 days a week, 8 hours a day for 8 weeks, and I saved my weekends for friends, work, and to relax.

     b.  Develop a Detailed Study Plan: Once you establish your timeline, you can then take the number of chapters in your comprehensive guide and divide up the work accordingly to the number of study days you will have. Perhaps each day you will plan to read 1-2 chapters and write 50 practice questions. You should also plan to have 3-5 buffer days dedicated for additional practice time or have a sick day to ensure that you stay on schedule.

Tip #3 KNOW HOW TO ANSWER NCLEX QUESTIONS

The NCLEX exam questions are designed to test how you would prioritize care, and as such when choosing your answer(s) you need to ask yourself “does this action immediately improve the patient/client’s safety?” Your strategy to answering questions should always consider ABCs, Maslow’s Hierarchy of Needs, The Nursing Process, and Client Safety Strategies.

     a.  ABCs:

 i.  Ask yourself if the question is asking you something specifically related to airway, breathing, or circulation. Airway problems or interventions to improve airway management are always the top priority, however…

 ii.  Airway is not always the answer just because it’s first. If the airway and breathing are NOT the problem in the situation, but circulation is impaired, don’t simply pick airway because it’s the first action with the ABCs. Pick the answer related to an action that will improve the circulation of the patient identified.

     b.  Maslow’s Hierarchy of Needs:

(1) Physiological Needs (breathing, food, water) -> 

(2) Safety and Security Needs (employment, property, family stability) -> 

(3) Love and Belonging (Friendship, family, intimacy) -> 

(4) Self-Esteem (confidence, achievement) -> 

(5) Self-Actualization (morality, creativity, acceptance)

 i.  Always address the physiologic needs BEFORE anything else. If there is more than one problem presented in the situation then you need to remember this. Physiologic first!

 ii.  Always apply physiological needs over psychological needs.

     c.  Nursing Process:

Nursing Assessment, Nursing Diagnosis, Planning, Intervention, Evaluation

 i.  Remember that assessment is the first step and is always required to plan care and provide a nursing intervention. However, you need to recognize that if the assessment has already been done for what the situation or scenario requires, then you would move along the nursing process to planning, and so on.

     d.  Client Safety Strategies:

 i.  Focus on: 

1.  Basic needs of the patient or client. (oxygen, fluids, nutrition)

2.  Reducing hazards that risk injury (accidents, obstacles)

3.  Reduce the risk of transmission of pathogens (immunizations, sanitization, hand hygiene)

 ii.  Know the seven medication rights

Tip #4 PRACTICE, PRACTICE, PRACTICE, AND THEN PRACTICE SOME MORE

     a.  The more you supplement your review with practice questions, the more prepared you will be for the NCLEX.

     b.  NCLEX practice question apps are great because they allow you to study anywhere and at any time. 

Tip #5 PLAN BREAKS AND MANAGE YOUR STRESS

     a.  Plan to have study breaks each day. Whether you decide to go for a walk, grab a snack somewhere, sit in the backyard and scroll Instagram, etc., just make sure that you take time for yourself. Self-care is important!

Tip #6 PREPARING FOR EXAM DAY!

i. Save all of your mental energy, stress, and focus for the NCLEX itself! So, to do this, let’s first eliminate or reduce all other possible stressors leading up to and on the exam day. 

     a.  Sleep: Plan on getting a good sleep the night before the exam and set multiple alarms.

     b.  Nutrition and fluids: Make sure you have healthy snacks and fluids available while you study and especially on exam day. You shouldn’t have to stress about what you are going to eat that morning!

     c.  Confirm the location and parking situation: Just like starting a new job, you should drive to the testing location beforehand, assess parking, and know how long of a walk it will be from your car to the building. I couldn’t think of a bigger nightmare arriving to take the exam and spending 20 minutes trying to figure out where to park or where to go.

     d.  Have your ID and mask ready: You will need to confirm your ID when you enter the testing station.  You will also need to bring a mask if you are writing the NCLEX during the Covid-19 pandemic.

     e.  Don’t bring anything that you don’t need: The testing center will have lockers, but it’s best to not bring anything that you do not need.

NCLEX Question Representation Breakdown:

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

·  Basic Care and Comfort 6-12%

·  Pharmacological and Parenteral Therapies 12-18%

·  Reduction of Risk Potential 9-15%

·  Physiological Adaptation 11-17%

12 Helpful Hints When Writing the NCLEX-RN Exam:

1)  Ask yourself, what exactly is the question asking of me. Do not read into the question for more than what it is. Keep it simple.

2)  Don’t look into any patterns. There is a possibility that you could have a number of select-all-that-apply questions in a row all with 4 correct answers 

3)  Highlight key words to help you prioritize what your action answer will be (e.g. first, early, best).

4)  Recognize absolute words in the answers (e.g. only, never, always, none, ever, must, cannot). It is rare that an absolute exists in health care, so it is unlikely that it will be the answer. Be mindful of this.

5)  Eliminate the answers that you are certain to be incorrect immediately in multiple choice questions. This automatically increases your odds of getting the question right from 25% to 33% or even 50%. At least one answer is typically clearly wrong.

6)  Focus on answers that directly affect the client.

7)  Always read the question and answers twice to make sure you don’t miss any key words (e.g. distractors, absolutes, action words).

8)  Rely on your memory for multiple choice questions as this style of question is more likely to be designed to test your knowledge and memory. Read the questions and attempt to recall the answer in your head before looking at the answers provided in the question itself. You should then choose the answer most similar to the one you recalled before you begin second guessing as the answers will be designed to trick you into thinking that they could all be correct.

9)  Answer every question and do not skip any. You do not have the option to go back and review your questions. Once you click submit, it is officially done.

10)  When presenting with select all that apply questions, the majority of the answers will likely somewhat relate to the situation or client, but you need to determine which ones directly relate to the situation or client.

11)  Most questions can be answered in two minutes or less, so do not spend an excessive period of time thinking about the question. Eliminate the answers you know are wrong. Ask yourself if the ABCs (focusing on airway first), Maslow’s Hierarchy of Needs (focusing on the physiologic need first), or Nursing Process (focusing on the assessment first) can apply, or if it is a client safety question. Make an educated guess from there. Even if you don’t know what the content is that the question is talking about, you can often answer the question simply by applying the above strategies.

12)  After you decide on an answer, re-read the question and ask yourself if the answer(s) you chose are both reasonable and realistic.

Frequently Asked Questions Regarding the NCLEX:

· Am I eligible to write the NCLEX? Contact your Nursing Regulatory Body (NRB). Typically, when you apply for a nursing license or registration within the state/provincial regulatory body that you were educated in you can seek authorization to write the NCLEX exam. The NRB will grant you Authorization to Take the Test (ATT) with instructions on how to schedule your NCLEX exam.

· Where can I take the NCLEX? USA, Canada, Australia, UK, India, Philippines, Mexico, Puerto Rico, Taiwan, Hong Kong, Guam, Northern Mariana Islands, U.S. Virgin Islands, Brazil, England, Japan, and South Africa.

     o The exam can be taken at Pearson Vue Testing Centers.

· How many questions are on the exam? 75-145 (As of October 1, 2020).

· What is the style of the NCLEX? The NCLEX uses the Computerized Adaptive Testing (CAT) format.

· How is the NCLEX graded? The NCLEX is a PASS/FAIL exam using the “logit” model which compares your ability to answer questions and the difficulty of the questions themselves. If you are able to correctly answer moderately difficult questions at least 50% of the time you are likely to pass.

     o The exam is completed when there is 95% certainty that your ability was either above or below the passing standard.

· How much time do you have to write the NCLEX? Up to 5 hours.

· How do you apply and register for the NCLEX? You must (1) Apply for a license or registration through your Nursing Regulatory Body (NRB) and (2) Register and pay the testing fee for the NCLEX through Pearson Vue. Once you are granted eligibility from the NRB and acknowledgment of both registration and payment from Pearson Vue is made you are then given Authorization to Take the Test (ATT). Remember that Medliant International Healthcare Staffing will reimburse the cost of your NCLEX-RN exam for successful candidates upon beginning employment in the US!

· If I fail the NCLEX, how often and how many times can I rewrite it? If you fail the NCLEX you can take the test again after 45 days test-free and up to 8 times a year.

· Can I take the NCLEX outside of my local or desired jurisdiction? Yes, once you are eligible to write the NCLEX you can take the exam at any Pearson Vue Testing Location. I recommend choosing a US state and applying for a “license through examination” meaning that if accepted and you pass the NCLEX-RN exam you will then be licensed in that US state. You do not have to take the NCLEX in that state itself as you can take it elsewhere in the world.

· How long will it take to get my NCLEX results? It can take up to 6 weeks to receive your testing results. In the USA you can access your “unofficial results” within 48 hours for a fee of $7.95 USD.

· Can I skip questions and go back to answer them later? No, you can only answer the questions in the order that you receive them with no opportunity to go back and answer them later.

· Do I get a performance report if I fail the exam? Yes.

· Will the names of medications be the generic or brand names in the NCLEX? The NCLEX generally uses only the generic names of medications.

· What languages are the NCLEX exam offered in? English and French (for French-speaking Canadian candidates).

· Are there breaks during the NCLEX exam? Yes, there are two breaks scheduled after 2 hours and after 3 ½ hours of commencement into the exam (please note: breaks do count towards testing time).

· Can I take the NCLEX during the Covid-19 pandemic? Yes. However, you will be required to wear a face mask.

If you are ready to begin your application to become a USRN with Medliant International Healthcare Staffing please reach out to us on the Medliant Website, Facebook (Medliant International Healthcare Staffing), or Instagram (@medliant).

You can also email me at nursebrennan@medliant.com with any questions or with your resume to begin your application today!

Nurse Brennan Belliveau

Email: nursebrennan@medliant.com

Medliant International Healthcare Solutions