NCLEX Questions Nursing Test Bank and Review

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NCLEX-RN-Nursing Test Bank 2020
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This guide is our nursing test bank for NCLEX practice questions with over 3,500 items from a wide range of nursing topics! Answer all the mock tests below to help you prepare and review for your NCLEX. Also in this guide is an overview of the NCLEX, understanding what it is and how it is administered is your first step on your way to becoming a registered nurse.

What is NCLEX?

NCLEX stands for National Council Licensing Examination, it is a test to determine if the candidate possesses the minimum level of knowledge necessary to perform safe and effective entry-level nursing care. The NCLEX-RN (for registered nurses) and the NCLEX-PN (for practical/vocational nurses) are examinations prepared by the National Council of State Boards of Nursing (NCSBN) whose mandate is to protect the public from unsafe nursing care. The NCSBN members include nursing regulatory bodies in the 50 states of the US, the District of Columbia and four US territories. 

NCLEX Changes for 2020: The NCSBN introduced a few modifications for the NCLEX examinations. For the summary of these modifications, please visit this link.

How to Register for the NCLEX?

So you’ve finally made the decision to take the NCLEX, the next step is registration or application for the exam. The following are the steps on how to register for the NCLEX including some tips:

  1. Application to the Nursing Regulatory Board (NRB).

    The initial step in the registration process is to submit your application to the state board of nursing in the state in which you intend to obtain licensure. Inquire with your board of nursing regarding the specific registration process as requirements may vary from state to state.

  2. Registration with Pearson VUE.

    Once you have received the confirmation from the board of nursing that you have met all of their state requirements, proceed, register, and pay the fee to take the NCLEX with Pearson VUE. Follow the registration instructions and complete the forms precisely and accurately.

  3. Authorization to Test.

    If you were made eligible by the licensure board, you will receive an Authorization to Test (ATT) form from Pearson VUE. You must test within the validity dates (an average of 90 days) on the ATT. There are no extensions or you’ll have to register and pay the fee again. Your ATT contains critical information like your test authorization number, validity date, and candidate identification number.

  4. Schedule your Exam Appointment.

    The next step is to schedule a testing date, time, and location at Pearson VUE. The NCLEX will take place at a testing center, you can make an exam appointment online or by telephone. You will receive a confirmation via email of your appointment with the date and time you choose including the directions to the testing center.

    *Changing Your Exam Appointment. You can change your appointment to test via Pearson VUE or by calling the candidate services. Rules for scheduling, rescheduling, and unscheduling are explained further here. Failing to arrive for the examination or failure to cancel your appointment to test without providing notice will forfeit your examination fee and you’ll have to register and pay again. 

  5. On Exam Day.

    Arrive at the testing center on your exam appointment date at least 30 minutes before the schedule. You must have your ATT and acceptable identification (driver’s license, passport, etc) that is valid, not expired, and contains your photo and signature.

  6. Processing Results.

    You will receive your official results from the board of nursing after six weeks.

Computer Adaptive Test (CAT)

Like most standardized tests today, the NCLEX is administered by a computer. The NCLEX uses computer adaptive test (CAT) which reacts to the answers you give to determine your level of competence. The selection of questions is based on the NCLEX-RN test plan and by the level of item difficulty. 

Every time you answer a question, the computer reevaluates your ability based on all the previous answers and difficulty of those test items. Your first question is relatively easy, if you selected a correct answer, the computer supplies you with a more difficult question from its question bank. If you have selected an incorrect answer, the computer gives you an easier question. This process continues throughout the examination until the test plan requirements are met and the computer is able to determine your level of competence.  

Additionally, there is no option to skip a question, you must answer it or the test will not move on. You cannot go back and review previous questions and change answers.

NCLEX-RN Test Plan

The NCLEX test plan is a content guideline to determine the distribution of test questions. NCSBN uses the “Client Needs” categories to ensure that a full spectrum of nursing activities is covered by the NCLEX. It is a summary of the content and scope of the NCLEX to serve as a guide for candidates preparing for the exam and to direct item writers in the development of items.  

The content of the NCLEX-RN is organized into four major Client Needs categories which include: Safe and Effective Care Environment, Health Promotion and Maintenance, Psychosocial Integrity, Physiological Integrity. Some of these categories are divided further into subcategories. 

Below is the NCLEX-RN test plan effective as of April 2019 to March 2022: 

Safe and Effective Care Environment 
Management of Care17-23%
Safety and Infection Control9-15%
Health Promotion and Maintenance6-12%
Psychosocial Integrity6-12%
Physiological Integrity 
Basic Care and Comfort6-12%
Pharmacological and Parenteral Therapies12-18%
Reduction of Risk Potential9-15%
Physiological Adaptation11-17%

Safe and Effective Care Environment

There are two subcategories under Safe and Effective Care Environment.

  • Management of Care (17-23%) category includes content that tests the nurse’s knowledge and ability to direct nursing care that enhances the care delivery setting in order to protect clients, significant others, and health care personnel. 
  • Safety and Infection Control (9-15%) category includes content that tests the nurse’s ability required to protect clients, families, and health care personnel from health and environmental hazards

Health Promotion and Maintenance 

Health Promotion and Maintenance (6-12%) category includes content that tests the nurse’s ability to provide and direct nursing care of the client that incorporates knowledge of expected growth and development; preventing and early detection of health problems, and strategies to achieve optimal health. 

Psychosocial Integrity 

The Psychosocial Integrity category (6-12%) are content related to the promotion and support for emotional, mental, and social well-being of the client experiencing stressful events, as well as clients with acute or chronic mental illness

Physiological Integrity

In the Physiological Integrity category are items that test the nurse’s ability to promote physical health and wellness by providing care and comfort, reducing risk potential and managing health alterations. There are four subcategories under Physiological Integrity. 

  • Basic Care and Comfort (6-12%) are content to test the nurse’s ability to provide comfort and assistance to the client in the performance of activities of daily living. 
  • Pharmacological and Parenteral Therapies (12-18%) category includes content to test the nurse’s ability to administer medications and parenteral therapies (IV therapy, blood administration, and blood products). 
  • Reduction of Risk Potential (9-15%) category includes content to tests the nurse’s ability to prevent complications or health problems related to the client’s condition or prescribed treatments or procedures. 
  • Physiological Adaptation (11-17%) category includes questions that test the nurse’s ability to provide care to clients with acute, chronic, or life-threatening conditions. 

Item Writers for NCLEX

Who writes questions for the NCLEX? The NCSBN sets the criteria and selection process for item writers who are registered nurses.  Many of them are nursing educators who hold an advanced degree in nursing so if you’ve completed an accredited nursing program, you have already taken several tests written by nurses with backgrounds similar to those who write for the NCLEX.

Testing Time

The maximum testing time for the NCLEX-RN is six (6) hours and there is no time limit for each individual NCLEX question. The exam time includes all the tutorials and all the breaks. The first break is offered after two (2) hours, the second break is offered after 3.5 hours of testing. All breaks are optional and most test-takers may not need the full time to complete the examination. 

How to Pass the NCLEX?

The NCSBN indicates that a pass-or-fail decision is governed by these three rules: 95% Confidence Interval Rule, Maximum-Length Exam Rule, and Run-Out-Of-Time Rule.

95% Confidence Interval Rule

In this scenario, the computer stops administering test questions when it is 95% certain that your ability is clearly above the passing standard or clearly below the passing standard. 

Maximum-Length Exam

When your ability is close to the passing standard, the computer continues to give you items until the maximum number of items is reached. At this point, the computer disregards the 95% confidence rule and decides whether you pass or fail by your final ability estimate. If your final ability estimate is above the passing standard, you pass; if it is below, you fail. 

Run-Out-Of-Time (R.O.O.T.) Rule

When you run out of time before reaching the maximum amount of items, the computer has not been able to decide whether you passed or failed with 95% certainty and has to use an alternate rule. If you have not answered the minimum number of required questions, you fail. If you have at least answered the minimum amount of items, the computer reviews your last 60 questions. If your ability estimate was consistently above the passing standard on the last 60 questions, you pass. If your ability dropped below the passing standard, even once, during your last 60 questions, you fail.

How many question are on the NCLEX?

For the NCLEX-RN, the minimum number of questions you need to answer is 75 while the maximum number in the test is 265. Regardless of the total number of questions you answer, you are given 15 questions that are experimental (pretest questions). Pretest questions are indistinguishable from other questions on the test, not indicated as such, are being tested for future examination and not counted against your score. 

Question Types in the NCLEX-RN

Although most NCLEX items are multiple-choice, there are other formats as well. You may be administered multiple-choice items and questions written in alternate formats. These formats may include: multiple-response or select all that apply, fill-in-the-blank calculation, ordered response, hotspot, figure, chart or exhibit, graphic, audio, and video.

Multiple-Choice Questions

Multiple-choice question format for the NCLEX
Multiple-choice question format for the NCLEX

Many questions on the NCLEX are in multiple-choice format. This traditional text-based question will provide you data about the client’s situation and you can only select one correct answer from the given four options. Multiple-choice questions may vary and include: audio clips, graphics, exhibits or charts.

Chart or Exhibit Questions

Chart or Exhibit Alternate Format for the NCLEX
Chart or exhibit question format

A chart or exhibit is presented along with a problem. You’ll be provided with three tabs or buttons that you need to click to obtain the information needed to answer the question. Select the correct choice among four multiple-choice answer options. 

Graphic Option

In this format, four multiple-choice answer options are pictures rather than text. Each option is preceded by a circle that you need to click to represent your answer.

Audio

In an audio question format, you’ll be required to listen to a sound to answer the question. You’ll need to use the headset provided and click on the sound icon for it to play. You’ll be able to listen to the sound as many times as necessary. Choose the correct choice from among four multiple-choice answer options. 

Video

For the video question format, you are required to view an animation or a video clip to answer the following question.  Select the correct choice among four multiple-choice answer options. 

Select All That Apply or Multiple-Response

Select All That Apply Question format for the NCLEX
Select-all-that-apply or multiple response

Multiple-response or select all that apply (SATA) alternate format question requires you to choose all correct answer options that relate to the information asked by the question. There are usually more than four possible answer options. No partial credit is given in the scoring of these items (i.e., selecting only 3 out of the 5 correct choices) so you must select all correct answers for the item to be counted as correct. 

Tips when answering Select All That Apply Questions

  • You’ll know it’s a multiple-response or SATA question because you’ll explicitly be instructed to “Select all that apply.”
  • Treat each answer choice as a True or False by rewording the question and proceed to answer each option by responding with a “yes” or “no”. Go down the list of answer options one by one and ask yourself if it’s a correct answer.
  • Consider each choice as a possible answer separate to other choices. Never group or assume they are linked together.

Fill-in-the-Blank

Fill-in-the-Blank question format for the NCLEX
Fill-in-the-blank

The fill-in-the-blank question format is usually used for medication calculation, IV flow rate calculation, or determining the intake-output of a client. In this question format, you’ll be asked to perform a calculation and type in your answer in the blank space provided. 

Tips when answering Fill-in-the-Blank

  • Always follow the specific directions as noted on the screen. 
  • There will be an on-screen calculator on the computer for you to use. 
  • Do not put any words, units of measurements, commas, or spaces with your answer, type only the number. Only the number goes into the box.
  • Rounding an answer should be done at the end of the calculation or as what the question specified, and if necessary, type in the decimal point. 

Ordered-Response

Ordered-response question format for the NCLEX
Ordered-response question format for the NCLEX

In an ordered-response question format, you’ll be asked to use the computer mouse to drag and drop your nursing actions in order or priority. Based on the information presented, determine what you’ll do first, second, third, and so forth. Directions are provided with the question. 

Tips when answering Ordered-Response questions

  • Questions are usually about nursing procedures. Imagine yourself performing the procedure to help you answer these questions.
  • You’ll have to place the options in correct order by clicking an option and dragging it on the box on the right. You can rearrange them before you hit submit for your final answer.

Hotspot

Hotspot Alternate Question Format for the NCLEX
Sample hotspot alternate question format

A picture or graphic will be presented along with a question. This could contain a chart, a table, or an illustration where you’ll be asked to point or click on a specific area. Figures may also appear along with a multiple-choice question. Be as precise as possible when marking the location. 

Tips when answering Hotspot questions

  • Mostly used to evaluate your knowledge of anatomy, physiology, and pathophysiology.
  • Locate anatomical landmarks to help you select the location needed by the item.

Want to test-drive the NCLEX? We highly recommend you complete the online tutorial by the NCSBN to help you familiarize yourself with the different question types for the NCLEX.

Test-Taking Strategies and Tips for NCLEX

Reviewing nursing concepts for your exam is just one part, you’ll need to learn how to answer correctly the questions too. Here are some test taking tips:

NCLEX-RN Test Bank

These practice questions are great if you want to simulate the actual exams since the questions are from random nursing topics.

Nursing Research

If you are looking for practice questions about nursing research, look no further!

Select All That Apply Quizzes

Test your nursing knowledge with these select all that apply questions!

Select All That Apply NCLEX Practice Question for Nursing

NEW: Select All That Apply NCLEX Practice Questions (100 Items)
A nursing test bank that will train you on how to answer SATA questions for the NCLEX.

Prioritization, Delegation, and Assignment

Practice nursing questions about prioritization, delegation, and assignment. These common NCLEX questions are difficult to answer but with enough practice using the questions below, you’ll ace them!

FB-NCLEX-–-Nursing-Prioritization-Delegation-Assignment-Practice-Questions

NEW: Prioritization, Delegation, and Assignment NCLEX Reviewer (100 Questions)
A nursing test bank that will train you on how to answer SATA questions for the NCLEX.

Arterial Blood Gas (ABG) Analysis

Quizzes about acid-base balance. For tips, read our 8-step Guide to Interpret ABGs using the Tic-Tac-Toe method.

FT-Arterial Blood Gas (ABGs) Interpretation NCLEX Quiz

NEW: Arterial Blood Gas Interpretation for NCLEX (40 Questions)
A nursing test bank that will train you on how to answer SATA questions for the NCLEX.

Nursing Leadership & Management

Practice questions related to nursing leadership and management:

Nursing Pharmacology

Questions related to administering medication safely are part of the NCLEX-RN. Prepare for these nursing pharmacology questions with these quizzes:

Dosage Calculations

We have consolidated our practice questions for drug dosage calculations in this set divided into four parts to test your skills in dosage calculations.

Drug Dosage Calculations NCLEX Practice Quiz

NEW: Drug Dosage Calculations NCLEX Practice Questions (100+ Items)
In this nursing test bank, practice dosage calculation problems to measure your competence in nursing math.

IV Flow Rate Calculations: NCLEX Practice Quiz

NEW: IV Flow Rate Calculations NCLEX Practice Questions (60 Items)
Practice your calculation skills on IV flow rate with this NCLEX practice quiz!

Fundamentals of Nursing

Practice exams about the foundations and fundamentals of nursing. Fundamentals of Nursing Quizzes 

Various topics about Fundamentals of Nursing

Maternal and Child Health Nursing

Questions in this set are about the care of the pregnant mother and her child.

Pediatric Nursing

A new set of questions related to the nursing care of youngsters.

Medical-Surgical Nursing

Assorted NCLEX practice questions about the vast concept of Medical-Surgical Nursing. Cardiovascular System NCLEX questions involving the cardiovascular system.

Respiratory System

Nursing test bank questions related to respiratory system disorders.

Nervous System

Practice questions related to nervous system disorders.

Digestive and Gastrointestinal System

Practice questions related to the gastrointestinal system and its disorders.

Endocrine System

Nursing test bank questions related to endocrine system.

Diabetes Mellitus Nursing Test Bank and NCLEX Reviewer

NEW: Diabetes Mellitus Reviewer and NCLEX Questions (100 Items)
Answer all the diabetes mellitus practice questions (100 items) from our nursing test bank and test your competence in the nursing management of diabetes.

Urinary System

Practice questions about the urinary system.

Homeostasis: Fluids and Electrolytes

Nursing test bank questions related to fluids and electrolytes.

Cancer and Oncology Nursing

Practice questions about cancer and oncology nursing.

Burns and Burn Injury Management

All questions related to burn injury nursing care.

Burns NCLEX Questions & Reviewer (100 Items)

NEW: Burns NCLEX Questions and Burn Injury Review
In this nursing test bank, we’ll test your knowledge on the concepts of burn injury nursing management

Emergency Nursing

Emergency nursing questions.

Miscellaneous

Mental Health and Psychiatric Nursing

NCLEX practice questions about Mental Health and Psychiatric Nursing. Comprehensive Mental Health and Psychiatric Nursing Questions

Growth and Development

Therapeutic Communication

Therapeutic Communication Techniques in Nursing NCLEX Practice Questions

NEW: Therapeutic Communication Techniques NCLEX Practice Quiz (50 Questions)
The best questions and reviewer to help you answer Therapeutic Communication questions in the NCLEX!

Mental Health and Psychiatric Disorders


NCLEX-RN Practice Questions and Review Tips
Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics and finding help online is near to impossible. His situation drove his passion for helping student nurses through the creation of content and lectures that is easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire students in nursing. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, breakdown complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.

31 COMMENTS

  1. Thank you so much for this free site. I found it just as helpful as Kaplan and Sanders which I paid for. I recommended this nurseslabs to some of my nurse friends preparing for the NCLEX. I used it to study and passed my NCLEX October 28. I will continue to use this as a reference. Once again Thank-You.
    A.Haynes RN

  2. Hey Matt,
    I am impressed by your generosity. I couldn’t believe these were all free. In all fairness, there should be a tab for donations for the constant upkeep of the web. A very minimal way to show our gratitude.

    Thanks.

    Hill

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  5. Thank you so much Nurse matt vera for this qbank,most beneficial, God bless you., if I may
    ask for some videos or pictures associated with the questions, will also help e.g lung sounds,abdominal sound etc thank you

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