The NCLEX is the final frontier of most nursing students to reach their dream of becoming a full-fledge registered nurse. But the NCLEX is definitely not easy and entails a lot of preparation to successfully hurdle this big challenge.
Luckily, there are many resources to help you pass the exam like answering practice questions, enrolling yourself in a review center, and also these 20+ brilliant tips and strategies every NCLEX taker should know:
1. Never choose an answer that leaves the patient.
Always provide safety.
2. Don’t “do nothing.”
Because you always have to do something.
3. Don’t read into the question.
Never assume anything that has not been specifically mentioned and don’t add extra meaning to the question.
4. Don’t pass the buck.
Never choose an answer that passes work off to anyone else.
5. If you see an option you have never heard of, do not choose it.
It’s like a signal from your brain that that is not the correct answer.
6. When choosing which patient to see first, choose the patient who is the most unstable.
Patients who are most likely to perish, most critical, or will suffer further injury without immediate action should be prioritized first.
7. Always assume the NCLEX hospital has unlimited staff, equipment, and resources.
Know that health care facilities in the NCLEX are always ideal.
8. Restraints are always the last option and are almost always the wrong answer.
9. Choose the least invasive choice first.
Issues concerning airway, breathing, or circulation should be addressed first, then move to choose the least invasive procedures (e.g., change of position, therapeutic communication with the patient).
10. Never choose an answer that delays treatment.
These distractors do not coincide to safe and effective nursing care.
11. Assess the client first, before implementing treatment.
If there’s a choice that pertains to assessment of the patient, choose that answer.
12. Find a commonality between the choices if you encounter a question which you are unfamiliar with.
If two or more answers are alike, choose the option that is different.
13. If the question includes the words “severe” or “acute” when referring to something such as pain, choose the answer that fixes that specific problem.
14. If the question is about endorsement, always report anything new or different to the next shift.
15. In general, put clients with the same or similar diagnoses in the same room.
16. After comprehending the question, decide what is the problem then pick answer that you can do as a nurse to solve it.
17. Select an answer that is focused on the client.
18. Answer select all that apply (SATA) questions as a true or false.
Go down the list of choices one by one and ask yourself if the choice answers the question. For more tips about SATA questions, see: 12 Tips to Answer NCLEX Select All That Apply (SATA) Questions.
19. Rephrase the question.
Putting the question in your own words can pluck the necessary info to reveal the core of the stem.
20. Make educated guesses.
If you can’t make the best answer for a particular question, give it a guess. The board exams is not a “right minus wrong” type. It is important for you to answer every question even if you have to guess.
21. Extra meaning need not apply!
Test questions are made to be direct and to the point so you don’t need to read extra meaning to the question. The question asks for one particular response and you should not read or add other information into the question. Often you will find questions that require “common sense” answers and that reading into these questions may give you another interpretation. You should not search for subtle meaning about the questions or answers. Ask yourself “What is the question asking?” Look for keywords and phrases to help you understand. Interpret the question correctly first before reading into the choices.
22. Understand the question
Make sure you read the stem correctly and notice particularly the way the question is phrased. Is it asking for the best response or the initial response? Understand what the question is asking before considering the distracter.
Rephrasing technique requires you to interpret or translate the question into your own words so that it is very clear in your own mind. Rephrasing the stem of the question can assist your read the question correctly and in turn choose the appropriate response. Placing the question into your own words would help you in removing extraneous data and get into the core of the stem.
When analyzing the distracter, isolate what is important in the answer alternatives from what is not important relative to the question. In a good test construction, all of the distracters should be feasible and reasonable and should apply directly to the stem. There should be a commonality in all of the distracter. Also, all of the distracters may be correct but not the right choice for the specific question that is being asked. The technique here is to ask yourself whether each possible alternative is true or false in relation to the stem.
Many test-takers fail to recheck the answer with the stem, and they answer the question incorrectly. After choosing the correct answer alternative and separating it from the distracter, go back to the stem and make sure your choice does, in fact, answer the question. An effective strategy is to judge all four alternative choices/options against the stem and not against one another. Read the stem, then check option 1 against the stem, then check option 2 against the stem, and so on. This process will eliminate choosing an alternative that does not fit with the question.
26. Process of Elimination
When a question contains multiple variables as alternative choices, use the “elimination of variable” technique. Each question may pose different alternatives with several variables. Use the process of elimination. Study the question first and ask yourself what variable fits with this condition, or after examining the distracter underline the symptom that you know is correct. Now ask yourself what variable is not present with this condition. Again examine the distracter and cross out those variables that are incorrect. By this process, you’ve probably eliminated at least two distracters even without taking the time to consider the other two.
27. Go back to the basics
When you come across a difficult question and you cannot immediately identify the answer, go back to your body of knowledge, and draw all the information that you do know about the condition. Don’t start being anxious and especially don’t panic! If you are unfamiliar with the disease or disorder and cannot choose the right nursing action, try to generalize to other situations. For example, if the question asks about dog bites, and you’ve never learned the course of the disorder, go back to an area of knowledge that you do know, for example, circulation and body response to toxic substances. Even though you do not know exactly what to do, you might know what not to do. Eliminate distracters to increase your chances of arriving at the correct answer.
28. Educated guesses
The ability to guess correctly is both a skill and an art.
The board exams are not a “right minus wrong” type. It is important for you to answer every question even if you have to guess. Guessing gives you only a 25% chance of getting the correct answer. Try to eliminate at least one (or more) distracter as this will increase the percentage margin of chance for guessing correctly. Examine the distracter and if one is the exact opposite of another (e.g. complete bed rest is different from activity as tolerated; both cannot be correct since they are of opposites), choose the one that seems to be most logical. Try to identify the underlying principle that supports the question. If you can answer the question, you might then be able to guess the correct answer. This strategy is especially true with a psychosocial question. Look at the way the alternatives are presented. Are there two answers that are very close? Often when this occurs, the ability to discriminate will show evidence of judgment. Check to see if one, more than the other, is the best choice for the question. Are there any distracters that are presented not logical (which are correct in themselves but do not have anything to do with the question)? Eliminate these and focus on other alternatives.
Use your intuition. If you cannot choose an alternative from a logical point, allow yourself to feel which one might be right. Often your subconscious mind will choose correctly (based on all the conscious knowledge you have of course) so simply let yourself feel which alternative might be right. Remember, it’s better to choose one answer than none at all.
29. Choosing an answer from a hunch
There comes a time when you are faced with a certain question and you have a hunch that this particular choice is correct. Do we depend on this “hunch?”. Current studies support that hunches are often correct, for they are based on rapid subconscious connections in the brain. Your stored knowledge, recall, and experience can combine to assist you in arriving at the correct answer. So, if you have an initial hunch, go with it! Do not change the answer if and only if, upon reflection, it just doesn’t seem right. On the other hand, if later in the test you find relevant information or make a new connection of information and you feel that your answer was incorrect, do go back and change it.
30. Choosing the best answer from a strategy point-of-view.
Frequently, the most comprehensive answer is the best choice (Longest the best!). For example, if two alternatives seem reasonable but one answer includes the other (i.e., it is more detailed, more comprehensive) than this answer would be the best choice. If an answer focuses on medical knowledge, be wary, for this alternative might be just a good distractor. Remember, this is a nursing test, and questions are designed to test your nursing competency and safety. It is unlikely that a question would require a medical action for the correct answer; it may, however, offer these actions as distracters. Beware of answers that contain specific qualifiers, such as “always’ and “never,” they rarely fit within a logical framework.
31. Read Questions Carefully
Scores on tests are greatly affected by reading ability. In answering a test item, you should begin by carefully reading the stem and then asking yourself the following questions:
- What is the question really asking?
- Are there any keywords?
- What information relevant to answering this question is included in the stem?
- How would I ask this question in my own words?
- How would I answer this question in my own words?
After you have answered these questions, carefully read the options, and then ask yourself the following questions:
- Is there an option that is similar to my answer?
- Is this option the best, most complete answer to the question?
Deal with the question as it is stated, without reading anything into it, or making assumptions about it. Answer the question asked, not the one you would like to answer. For simple recall items, the self-questioning process usually will be completed quickly. For more complex items the self-questioning process may take longer, but it should assist you in clarifying the item and selecting the best response.
32. Identify Keywords
Certain keywords in the stem, the options, or both should alert you to the need for caution in choosing your answer. Because few things are absolute without exception, avoid selecting answers that include words such as always, never, all, every, only, must, no, except, and none. Answers containing these keywords are rarely correct because they place special limitations and qualifications on potentially correct answers. For example:
All of the following are services of the National Kidney Foundation except:
1. Public education programs
2. Research about kidney disease
3. Fund-raising affairs for research activities
4. Identification of potential transplant recipients
This stem contains two keywords: all and except. They limit the correct answer choice to the one option that does not represent a service of the National Kidney Foundation. When except, not, or a phrase such as all but one of the following appears in the stem, the inappropriate option is the correct answer—in this instance, option 4.
If the options in an item do not seem to make sense because more than one option is correct, reread the question; you may have missed one of the keywords in the stem. Also, be on guard when you see one of the keywords in an option; it may limit the context in which such an option would be correct.
33. Pay Attention to Specific Details
The well-written multiple-choice question is precisely stated, providing you with only the information needed to make the question or problem clear and specific. A careful reading of details in the stem can provide important clues to the correct option. For example:
A male client is told that he will no longer be able to ingest alcohol if he wants to live. To effect a change in his behavior while he is in the hospital, the nurse should attempt to:
1. Help the client set short-term dietary goals
2. Discuss his hopes and dreams for the future
3. Discuss the pathophysiology of the liver with him
4. Withhold approval until he agrees to stop drinking
The specific clause to effect a change in his behavior while he is in the hospital is critical. Option 2 is not really related to his alcoholism. Option 3 may be part of educating the alcoholic, but you would not expect a behavioral change observable in the hospital to emerge from this discussion. Option 4 rejects the client as well as his behavior instead of only his behavior. Option 1, the correct answer, could result in an observable behavioral change while the client is hospitalized; for example, he could define ways to achieve short-term goals relating to diet and alcohol while in the hospital.
34. Eliminate Clearly Wrong or Incorrect Answers
Eliminate clearly incorrect, inappropriate, and unlikely answers to the question asked in the stem. By systematically eliminating distractors that are unlikely in the context of a given question, you increase the probability of selecting the correct answer. Eliminating. obvious distractors also allow you more time to focus on the options that appear to be potentially sound answers to the question. For example:
The four levels of cognitive ability are:
1. Assessing, analyzing, applying, evaluating
2. Knowledge, analysis, assessing, comprehension
3. Knowledge, comprehension, application, analysis
4. Medical-surgical nursing, obstetric nursing, psychiatric nursing
Option 1 contains both cognitive levels and nursing behaviors, thus eliminating it from consideration. Option 4 is clearly inappropriate since the choices are all clinical areas. Both options 2 and 3 contain levels of cognitive ability; however, option 2 includes assessing, which is a nursing behavior. Therefore option 3 is correct. By reducing the plausible options, you reduce the material to consider and increase the probability of selecting the correct option.
35. Identify Similar Options
When an item contains two or more options that are similar in meaning, the successful test taker knows that all are correct, in which case it is a poor question, or that none is correct, which is more likely to be the case. The correct option usually will either include all the similar options or exclude them entirely. For example:
When teaching newly diagnosed diabetic clients about their condition, it is important for the nurse to focus on:
1. Dietary modifications
2. Use of sugar substitutes
3. Their present understanding of diabetes
4. Use of diabetic nutritional exchange lists
Options 1, 2, and 4 deal only with the diabetic diet, involving no other aspect of diabetic teaching; it is impossible to select the most correct option because each represents equally plausible, though limited, answers to the question. Option 3 is the best choice because it is most complete and allows the other three options to be excluded. As another example:
A child’s intelligence is influenced by:
1. A variety of factors
2. Socioeconomic factors
3. Heredity and environment
4. Environment and experience
The most correct answer is option 1. It includes the material covered by the other options, eliminating the need for an impossible choice, since each of the other options is only partially correct.
36. Identify Answer (Option) Components
When an answer contains two or more parts, you can reduce the number of potentially correct answers by identifying one part as incorrect. For example:
After a cholecystectomy the postoperative diet is usually:
1. High fat, low calorie
2. High fat, low protein
3. Low fat, high calorie
4. Low fat, high protein
If you know, for instance, that the diet after cholecystectomy is usually low or moderate in fat, you can eliminate options 1 and 2 from consideration. If you know that the cholecystectomy client usually is overweight, you can eliminate option 3 from consideration. Therefore option 4 is correct.
37. Identify Specific Determiners
When the options of a test item contain words that are identical or similar to words in the stem, the alert test taker recognizes the similarities as clues about the likely answer to the question. The stem word that clues you to a similar word in the option or that limits potential options is known as a specific determiner. For example:
The government agency responsible for administering the nursing practice act in each state is the:
1. Board of regents
2. Board of nursing
3. State nurses’ association
4. State hospital association
Options 2 and 3 contain the closely related words nurse and nursing. The word nursing, used both in the stem and in option 2, is a clue to the correct answer.
38. Identify Words in the Options That Are Closely Associated With Words in the Stem
Be alert to words in the options that may be closely associated with but not identical to a word or words in the stem. For example:
When a person develops symptoms of physical illness for which psychogenic factors act as causative agents, the resulting illness is classified as:
4. Reaction formation
Option 3 should strike you as a likely answer since it combines physical and psychologic factors, like those referred to in the stem.
39. Watch for Grammatical Inconsistencies
If one or more of the options are not grammatically consistent with the stem, the alert test taker usually can eliminate these distractors. The correct option must be consistent with the form of the question. If the question demands a response in the singular, plural options usually can be safely eliminated. When the stem is in the form of an incomplete sentence, each option should complete the sentence in a grammatically correct way. For example:
Communicating with a male client who is deaf will be facilitated by:
1. Use gestures
2. Speaking loudly
3. Find out if he has a hearing aid
4. Facing the client while speaking
Options 1 and 3 do not complete the sentence in a grammatically correct way and can therefore be eliminated. Option 2 would be of no assistance with a deaf client, so option 4 is the correct answer.
40. Be Alert to Relevant Information From Earlier Questions
Occasionally, remembering information from one question may provide you with a clue for answering a later question. For example:
A client has an intestinal tube inserted for treatment of intestinal obstruction. Intestinal suction can result in excessive loss of:
1. Protein enzymes
2. Energy carbohydrates
3. Water and electrolytes
4. Vitamins and minerals
If you determined that the correct answer to this question was option 3, it may help you to answer a later question. For example:
Critical assessment of a client with intestinal suction should include observation for:
The correct answer is option 4. If you knew that excessive loss of water and electrolytes may lead to dehydration, you could have used the clue provided in the earlier question to assist you in answering the latter question.
41. Make Educated Guesses
When you are unsure about the correct answer to a question, it is better to make an educated guess than not to answer the question. You generally can eliminate one or more of the distractors by using partial knowledge and the methods just listed. The elimination process increases your chances of selecting the correct option from those remaining. Elimination of two distractors on a four-option multiple-choice item increases your probability of selecting the correct answer from 25% to 50%.
42. Beware of ‘Always’ and ‘Never’
Be cautious of the ‘always’ and ‘never’ questions. Very few times does the answer include these words. It implies that there is no room for exception.
43. Watch out for Negative Modifiers
An example would be “Which of these answers is NOT the best response?”
If you miss those keywords, you will likely miss the question. The correct answer could possibly be a negative response.
44. Focus on the Patient
The focus of care should always be on the patient. The opinions of coworkers or physicians are not as important.
45. Safety is a priority
Patient safety is always a top priority. The safety of the patient takes precedence over patient satisfaction. The correct answer is likely the answer that addresses patient safety.
46. FIRST actions
Look for the keyword ‘first.’ All answers may be correct, but the question is what the nurse’s FIRST action should be. Don’t skim past the seemingly meaningless word.
47. Assess Before Action
When in doubt, assess the patient before acting upon the problem. Rule of nursing-assess first!
48. Eliminate Obviously Wrong Answers
Oftentimes, there is at least one “duh” option. Eliminate those first. Then, you’re looking at a 33% chance of success.
49. Don’t Overlook Obviously Correct Answers
Sometimes, the correct answer is too easy. Consider it a freebie. The test makers are giving you a break.
50. Don’t Spend Too Much Time
Pace yourself. Don’t spend too much time on one question. If you absolutely DO NOT know the answer, give it your best guess and move on. You will have more time to answer the questions that you DO know.
51. Go with Your Gut
You are smart. You have all the knowledge that you need. DON’T change your answers unless you are 110% sure the answer that you have already selected is incorrect. Most of the time, your first instinct is correct.
So, there you have it! I hope these tips have eased a little of your test-taking anxiety. Good luck! You’ve got this!
These tips and strategies are just one way of preparing for the NCLEX. To come fully equipped for the exam, try out our practice NCLEX questions.