Strategies for the NCLEX PN and RN

Test Taking Strategies for the NCLEX PN and RNHelen Taylor, R.N., J.D.

Professional Medical Careers Institutewww.pmcicareers.com

Read the question carefully to determine the key concept.

Key concepts include determining who the client is, what the problem is, what is being asked about the problem and what the time frame is.

Look for Key Concepts

Read, re-read and Re-phrase the question – know what the question is asking you to do.

Evaluate each answer (consider each) Visualize yourself saying or doing something Identify KEY words in the question and answer Eliminate wrong answers (start eliminating) Weigh each answer – does it relate to the

question?

Remember to REVIEW

Look for words that focus on the issue. Look for: Early or Late symptoms; most

or least likely to occur. These words are easy to miss unless

you practice LOOKING for them Look for INITIAL nursing action. This

means the first thing you will do as a nurse.

Think of the FIRST STEP in the Nursing Process – assessment – you will ASSESS first before intervening.

Look for Key Words

When the question asks what is ESSENTIAL – THINK SAFETY and Prevention of Serious Complications

Essential means that you must do it and IT CANNOT BE LEFT UNDONE!

When setting priorities remember MASLOW’s HIERACHY of needs. The first level needs come first

REMEMBER – “Keep them breathing, keep them safe.”

Also consider which actions will prevent complications – these are essential things that you must do to keep the patient safe and alive.

“ESSENTIAL” QUESTIONS

The option that is most different in length, style or content is usually correct.

The correct answer is often the longest or the shortest.

If two or three answers say the same, think in different words – they can’t all be correct

(poor appetite and anorexia are examples)

The Odd Man Wins

When two answers are opposites, such as hypotension and hypertension – the answer is usually one of the two.

An adult is admitted in shock. Which assessment finding would you expect to find?1. Elevate blood pressure2. Low blood pressure3. Slow Pulse4. Flushed color.

Choices 1 and 2 are opposites. The answer will most likely be one of those. The answer is 2.

Opposites

Absolutes tend to make answers WRONG

Look for: ALWAYS, NEVER, ALL and NONE

These are usually incorrect statements. QUALIFIED ANSWERS such as: USUALLY, FREQUENTLY, and OFTEN are usually CORRECT.

ABSOLUTES – Make Answers Wrong

ALWAYS read the question and all of the answers CAREFULLY before selecting the correct response.

If the answer does not appear obvious – ELIMINATE answers that CANNOT be correct.

Read the Question Carefully

Remember the ANSWER MUST RELATE TO THE QUESTION!

If you do not know – Make an educated guess and then MOVE ON to the next question.

Work Cited: Judith Miller. Delmar’s NCLEX PN review second edition.2011

The Answer Must Relate

Don’t READ INTO the question Focus only on the information in the

question Read every word and decide what the

question is asking. Look for strategic words Always use the process of elimination Determine if the question is a positive

or negative event query.

Avoid “what if…”

Early or Late Best First Initial Immediately Most Likely or least likely Most appropriate or least appropriate

Identify Common Strategic Words

A positive event query uses strategic words that ask you to select an option that is CORRECT.

A negative event query uses strategic words that ask you to select an option that is INCORRECT.

A common one: “Which statement indicates a client’s need for further teaching”

Positive and Negative Event Queries

REMEMBER: MANS Maslow – basic needs take priority over higher needs

(air, water, food, safety) ABC;s (Keep them breathing – look for things that could

affect airway, breathing or circulation – these take priority)

Nursing Process – remember ADPIE – always ASSESS before you intervene. Also it’s usually something that requires a license to do (like check the NG tube for placement or assess fetal heart tones) Those things that assistive personnel can do are usually not the thing that the NURSE must do.

Think SAFETY – what will keep the patient/nurse SAFE

For Priority Questions

These require you to use the skill of prioritization of nursing action

When it is a priority question – usually all options may be correct.

Use the ABC’s, Maslow and the Nursing Process Steps to determine your answer.

Priority Questions

Safe Effective Care Environment (15% of test)

◦These questions test the concepts that the nurse provides nursing care, collaborates with others and protects clients and others from hazards.

◦FOCUS on Safety. Remember the importance of hand-washing, call lights, bed positions and the use of side rails.

CLIENT NEEDS

These questions test the concepts that the nurse provides COMFORT and ASSISTANCE with the ADL’s, and care related to the administration of medication.

◦REDUCING potential for complications related to treatments, procedures or existing conditions

◦Remember MASLOW – the PHYSIOLOGICAL NEEDS take priority and are addressed first.

Physiological Integrity (60% of test)

These test the concepts that the nurse provides nursing care that promotes and supports the emotional, mental and social well-being of the client and family.

Content in these questions relates to promoting the ability to cope, adapt or problem solve in situations such as illnesses, disabilities or stressful events such as abuse, neglect or violence.

Psychosocial Integrity (10-15% of test)

Tests the concepts that the nurse provides to assist in directing nursing care to promote and maintain health

Relates to assisting the client during the normal expected stages of growth and development from conception through old-age.

Providing care related to the prevention and early detection of health problems

Health Promotion and Maintenance (15% of test)

Close ended words include:

◦All Always Every◦Must None Never◦Only

Eliminate these options because these words infer a FIXED or EXTREME meaning. These types of options are usually incorrect

Eliminate Options with CLOSED-ENDED WORDS

Always look for the UMBRELLA option

The umbrella option is one that is a BROAD or UNIVERSAL statement and usually contains the concepts of the others options with it.

The UMBRELLA option will often be the CORRECT Answer

Look for the Umbrella Option

A client is admitted and is diagnosed with urethritis caused by chlamydial infection. The nurse assigned to the client understands that what precautions are necessary to prevent contraction of the infection during care?

1. Enteric Precautions 2. Contact Precautions 3. Standard Precautions 4. Wearing gloves and a mask

Recall the this infection is sexually transmitted. Also note that 3 is the umbrella option. It is correct.

Example of an Umbrella Option

Always think about the job description or role of the employee

Think about the needs of the client Remember to match the client needs

with the scope of practice of the health care provider. KEY

Someone needing tube feedings and dressing changes would need a licensed nurse

Use Guidelines for Delegating and Making Assignments

If you are familiar with it use your nursing knowledge

The question will ID both the generic and trade names of the medication

If the question identifies a medical diagnosis try to make a relationship between the medication and the diagnosis

Try to determine the CLASSIFICATION of the medication to determine it’s action or side effects

Pharmacology Questions

Use medical terminology to assist in determining the action of the medication

◦Lopressor- Lowers (lo) the blood pressure (pressor)

Medications of a class will have similar actions, side effects and nursing precautions.

Often side effects will depend on the action of the drug.

Review Common Classifications