How to Answer the Different Types of NCLEX-RN Questions

Hello everyone! My name is Nurse Brennan from Medliant International Healthcare Staffing and The Adventurous Nurse Ltd. I am going to breakdown the different types of questions that you will see on the NCLEX-RN Exam!

The NCLEX-RN Exam is the entry-to-practice exam for all Registered Nurses in the United States. Unlike many exams that you may be used to, the NCLEX is a computerized exam comprised of a variety of types of questions that you will see. There is no way to predict what types of questions you will get, however, if you get one question right, it is likely that the next question will be more difficult. The same can be said that if you get a question wrong, it is likely that the next question will be easier. Your final grade is either a pass or a fail and is determined when the testing software is 95% satisfied that you have proven to remain above or below a specific threshold.

Now let’s get into the types of questions that you will see!

One of the most common types of questions that you will see are…

1)    Multiple Choice Questions

The NCLEX will often start out with simple multiple-choice questions, consisting of 4 possible answers. There are 3 components to these questions, and they include:

1)    The stem of the question which will either relate to a client, a health need, scenario, or other important information needed to answer the question properly. Next, we have

2)    3 Distractors, which are incorrect answers that will try to trick you into believing that they could be correct, followed by

3)    1 Correct Answer

There is usually one answer that is more obviously wrong than the other two distractors. If you are able to eliminate this wrong answer immediately, then you now increase the odds of correctly answering the question from 25% to 33%. The other two distractors will be designed to trick you into believing they could be correct often by relating to the stem the question. You will need to remember to apply the ABCs, Maslow’s Hierarchy of Needs, and the Nursing Process to ask yourself which of the remaining answers is the priority.

Let’s take a look at an example:

There is usually one answer that is more obviously wrong than the other two distractors. If you are able to eliminate this wrong answer immediately, then you now increase the odds of correctly answering the question from 25% to 33%. The other two distractors will be designed to trick you into believing they could be correct often by relating to the stem the question. You will need to remember to apply the ABCs, Maslow’s Hierarchy of Needs, and the Nursing Process to ask yourself which of the remaining answers is the priority.

Let’s take a look at an example:

Answer:

The correct answer is A, stop the infusion. The first action the nurse should take is to prevent any more medication from entering the patient and causing damage to surrounding tissues. The other answers are incorrect as you would contact the physician, but not until after you stopped the infusion, you would inform the patients nurses, however the patients safety and care is the highest priority and interventions to prevent further harm should not be delayed, and you would aspirate any medication that may be remaining in the IV line after the infusion has stopped.

As we discussed earlier, the obvious distracter to eliminate is C, “contacting the patients nurse since it is not your patient.” As this intervention would not directly relate to the patient, prevent further harm, or alleviate pain or discomfort this is not the first action the nurse should take. The other two distracters B and D, contacting the physician and aspirate any medication that may be remaining in the IV line, could trick you into believing that these answers are correct as they are interventions that you would perform, however, we must remember that the question is asking us, what would be the first action, and that of course would be to stop the infusion.

Another common type of question that you will see is….

2)    Multiple Response or Select All That Apply Questions 

Multiple Response or Select All That Apply Questions can have up to 6 answers to choose from with as little as one correct answer and as many as 6 correct answers. The first step is to determine which of the 6 answers are correct, and not just the best answers. One way to approach these questions is to treat each answer as a True or False response. To get the question correct, you will need to successfully choose which of the answers are correct and which ones are incorrect. There are no partial marks for getting the question partially correct.

Let’s take a look at an example:

Answer:

The correct answers are A, B, D, F, fever, fatigue, hypotension, and an altered level of consciousness are all common symptoms associated with sepsis. The other answers are incorrect as patient with sepsis often have tachycardia to compensate for compromised circulation and perfusion, and not bradycardia. And a decreased urine output is expected as kidney function is impaired, and the patient becomes edematous. 

As we can see with this example, it is possible to choose if each answer is correct or incorrect using the true or false method for each one. The two incorrect answers are chosen as distractors, because while they are incorrect, the heart rate and urine output are altered with patients who have sepsis and may trick you into believing that they could also be correct.

A less common type of question that you will see is called…

3)    Hot Spot Questions

Hot Spot Questions include an image or table and are used to test your knowledge of key nursing concepts such as anatomy or physiology.

Let’s take a look at an example:

Answer:

 The fifth Intercostal space at the left midclavicular line is the best location to auscultate the mitral area using a stethoscope

Another less common type of question you will see on the NCLEX are 

4)    Fill-In-The-Blank Questions

These questions often use numerical answers for a response, such as with a medication calculation question. Yes, you will be given a calculator on your screen to use in the event that you will require one to answer a question.

Let’s take a look at an example:

Answer:

The correct answer is 385mg/dose

To calculate the answer, you would take the weight of 19kg and the safe dosing calculation of 15mg/kg/dose and multiple the weight into it. You would then get 15mg x 19kg /dose = 285mg/dose

Other types of questions that you will see include: 

5)    Audio Questions (You will listen to an audio clip to answer the question)

6)    Ordered Response (You will rank the answers accordingly)

7)    Graphic (You will select the correct image to answer the question)

If you are ready to begin your application to become a US Registered Nurse 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 your resume to nursebrennan@medliant.com to start making your American Dream come true!

Nurse Brennan Belliveau

Email: nursebrennan@medliant.com

Medliant International Healthcare Solution