Welcome to our collection of free NCLEX practice questions to help you achieve success on your NCLEX-RN exam! This updated guide for 2022 includes 1,000+ practice questions, a primer on the NCLEX-RN exam, frequently asked questions about the NCLEX, question types, the NCLEX-RN test plan, and test-taking tips and strategies.
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For more NCLEX practice questions, please visit our Nursing Test Bank here.
NCLEX-RN Practice Questions Test Bank
We have included more than 1,000+ NCLEX practice questions covering different nursing topics for this nursing test bank! We’ve made a significant effort to provide you with the most challenging questions along with insightful rationales for each question to reinforce learning.
We recommend you do all practice questions before you take the actual exam. Doing so will help reduce your test anxiety and help identify nursing topics you need to review. To make the most of the practice exams, try to minimize mistakes to less than 15 questions and take your time answering the questions, especially when reading the rationales.
Included NCLEX-RN question sets for this nursing test bank are as follows:
- Comprehensive NCLEX-RN Practice Questions | Quiz #1: 75 Questions
- Comprehensive NCLEX-RN Practice Questions | Quiz #2: 75 Questions
- Comprehensive NCLEX-RN Practice Questions | Quiz #3: 75 Questions
- Comprehensive NCLEX-RN Practice Questions | Quiz #4: 75 Questions
- Comprehensive NCLEX-RN Practice Questions | Quiz #5: 75 Questions
- Comprehensive NCLEX-RN Practice Questions | Quiz #6: 75 Questions
- Comprehensive NCLEX-RN Practice Questions | Quiz #7: 75 Questions
- Comprehensive NCLEX-RN Practice Questions | Quiz #8: 75 Questions
- Comprehensive NCLEX-RN Practice Questions | Quiz #9: 75 Questions
- Comprehensive NCLEX-RN Practice Questions | Quiz #10: 75 Questions
- Comprehensive NCLEX-RN Practice Questions | Quiz #11: 75 Questions
- Comprehensive NCLEX-RN Practice Questions | Quiz #12: 75 Questions
- More practice questions available at our Nursing Test Bank.
- See also: FULL-TEXT Comprehensive NCLEX-RN Practice Quiz Test Bank (900 Questions)
- Comprehend each item. Read and understand each question before choosing the best answer. The exam has no time limit so that you can make sense of each item at your own pace.
- Review your answers. Once you’re done with all the questions, you’ll be redirected to the Quiz Summary table, where you’ll be able to review which questions you’ve answered or may have skipped. Review your answers once more before pressing the Finish Quiz button.
- Read the rationales. After you have reviewed your answers, click on the Finish Quiz button to record your answers and show your score. Click on the View Questions button to review the quiz and read through the rationales for each question.
- Let us know your feedback! Comment us your thoughts, scores, ratings, and questions about the quiz in the comments section below.
NCLEX-RN Practice Questions | Quiz #12: 75 Questions
Welcome to another set of NCLEX-RN practice questions. If you have completed this 12th set, you have answered 900 NCLEX practice questions!
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Where are the rationales? Please click the View Questions button below to review your answers and read through the rationales for each question.
Question 1 of 75
1. QuestionCategory: Physiological Adaptation
Among the following signs and symptoms, which would most likely be present in a client with mitral regurgitation?CorrectIncorrect
Question 2 of 75
2. QuestionCategory: Physiological Adaptation
Kris with a history of chronic infection of the urinary system complains of urinary frequency and burning sensation. To figure out whether the current problem is of renal origin, the nurse should assess whether the client has discomfort or pain in the:CorrectIncorrect
Question 3 of 75
3. QuestionCategory: Physiological Adaptation
Nurse Perry is evaluating the renal function of a male client. After documenting urine volume and characteristics, Nurse Perry assesses which signs as the best indicator of renal function.CorrectIncorrect
Question 4 of 75
4. QuestionCategory: Physiological Adaptation
John suddenly experiences a seizure, and Nurse Gina notices that John exhibits uncontrollable jerking movements. Nurse Gina documents that John experienced which type of seizure?CorrectIncorrect
Question 5 of 75
5. QuestionCategory: Health Promotion and Maintenance
Smoking cessation is a critical strategy for the client with Buerger’s disease, Nurse Jasmin anticipates that the male client will go home with a prescription for which medication?CorrectIncorrect
Question 6 of 75
6. QuestionCategory: Physiological Adaptation
Nurse Lilly has been assigned to a client with Raynaud’s disease. Nurse Lilly realizes that the etiology of the disease is unknown but it is characterized by:CorrectIncorrect
Question 7 of 75
7. QuestionCategory: Health Promotion and Maintenance
Nurse Jamie should explain to a male client with diabetes that self-monitoring of blood glucose is preferred to urine glucose testing because:CorrectIncorrect
Question 8 of 75
8. QuestionCategory: Physiological Adaptation
Jessie weighed 210 pounds on admission to the hospital. After 2 days of diuretic therapy, Jessie weighs 205.5 pounds. The nurse could estimate the amount of fluid Jessie has lost:CorrectIncorrect
Question 9 of 75
9. QuestionCategory: Physiological Adaptation
Nurse Donna is aware that the shift of body fluids associated with Intravenous administration of albumin occurs in the process of:CorrectIncorrect
Question 10 of 75
10. QuestionCategory: Reduction of Risk Potential
Myrna, a 52-year-old client with a fractured left tibia, has a long leg cast and she is using crutches to ambulate. Nurse Joy assesses for which sign and symptom that indicates complication associated with crutch walking?CorrectIncorrect
Question 11 of 75
11. QuestionCategory: Health Promotion and Maintenance
Which of the following statements should the nurse teach the neutropenic client and his family to avoid?CorrectIncorrect
Question 12 of 75
12. QuestionCategory: Physiological Adaptation
A female client is experiencing a painful and rigid abdomen and is diagnosed with a perforated peptic ulcer. A surgery has been scheduled and a nasogastric tube is inserted. The nurse should place the client before surgery inCorrectIncorrect
Question 13 of 75
13. QuestionCategory: Physiological Adaptation
Which nursing intervention ensures adequate ventilating exchange after surgery?CorrectIncorrect
Question 14 of 75
14. QuestionCategory: Reduction of Risk Potential
George, who has undergone thoracic surgery has a chest tube connected to a water-seal drainage system attached to suction. Presence of excessive bubbling is identified in the water-seal chamber, the nurse should:CorrectIncorrect
Question 15 of 75
15. QuestionCategory: Health Promotion and Maintenance
A client who has been diagnosed with hypertension is being taught to restrict intake of sodium. The nurse would know that the teachings are effective if the client states that:CorrectIncorrect
Question 16 of 75
16. QuestionCategory: Physiological Adaptation
A male client with a history of cirrhosis and alcoholism is admitted with severe dyspnea resulting from ascites. The nurse should be aware that the ascites is most likely the result of increased:CorrectIncorrect
Question 17 of 75
17. QuestionCategory: Management of Care
A newly admitted client diagnosed with Hodgkin’s disease undergoes an excisional cervical lymph node biopsy under local anesthesia. What does the nurse assess first after the procedure?CorrectIncorrect
Question 18 of 75
18. QuestionCategory: Physiological Adaptation
A client has 15% blood loss. Which of the following nursing assessment findings indicates hypovolemic shock?CorrectIncorrect
Question 19 of 75
19. QuestionCategory: Reduction of Risk Potential
Nurse Lucy is planning to give preoperative teaching to a client who will be undergoing rhinoplasty. Which of the following should be included?CorrectIncorrect
Question 20 of 75
20. QuestionCategory: Physiological Adaptation
Paul is admitted to the hospital due to metabolic acidosis caused by Diabetic ketoacidosis (DKA). The nurse prepares which of the following medications as an initial treatment for this problem?CorrectIncorrect
Question 21 of 75
21. QuestionCategory: Health Promotion and Maintenance
Dr. Marquez tells a client that an increased intake of foods that are rich in Vitamin E and beta-carotene are important for healthier skin. The nurse teaches the client that excellent food sources of both of these substances are:CorrectIncorrect
Question 22 of 75
22. QuestionCategory: Health Promotion and Maintenance
A client has Gastroesophageal Reflux Disease (GERD). The nurse should teach the client that after every meal, the client should:CorrectIncorrect
Question 23 of 75
23. QuestionCategory: Reduction of Risk Potential
After gastroscopy, an adaptation that indicates major complication would be:CorrectIncorrect
Question 24 of 75
24. QuestionCategory: Health Promotion and Maintenance
A client who has undergone a cholecystectomy asks the nurse whether there are any dietary restrictions that must be followed. Nurse Hilary would recognize that the dietary teaching was well understood when the client tells a family member that:CorrectIncorrect
Question 25 of 75
25. QuestionCategory: Physiological Adaptation
Nurse Rachel teaches a client who has been recently diagnosed with hepatitis A about untoward signs and symptoms related to Hepatitis that may develop. The one that should be reported immediately to the physician is:CorrectIncorrect
Question 26 of 75
26. QuestionCategory: Pharmacological and Parenteral Therapies
Which of the following antituberculosis drugs can damage the 8th cranial nerve?CorrectIncorrect
Question 27 of 75
27. QuestionCategory: Physiological Adaptation
The client asks Nurse Annie the causes of peptic ulcer. Nurse Annie responds that recent research indicates that peptic ulcers are the result of which of the following:CorrectIncorrect
Question 28 of 75
28. QuestionCategory: Physiological Adaptation
Ryan has undergone a subtotal gastrectomy. The nurse should expect that nasogastric tube drainage will be what color for about 12 to 24 hours after surgery?CorrectIncorrect
Question 29 of 75
29. QuestionCategory: Physiological Adaptation
Nurse Joan is assigned to come for a client who has just undergone eye surgery. Nurse Joan plans to teach the client activities that are permitted during the postoperative period. Which of the following is best recommended for the client?CorrectIncorrect
Question 30 of 75
30. QuestionCategory: Physiological Adaptation
A client suffered from a lower leg injury and seeks treatment in the emergency room. There is a prominent deformity to the lower aspect of the leg, and the injured leg appears shorter than the other leg. The affected leg is painful, swollen and beginning to become ecchymotic. The nurse interprets that the client is experiencing:CorrectIncorrect
Question 31 of 75
31. QuestionCategory: Pharmacological and Parenteral Therapies
Nurse Jenny is instilling an otic solution into an adult male client’s left ear. Nurse Jenny avoids doing which of the following as part of the procedureCorrectIncorrect
Question 32 of 75
32. QuestionCategory: Reduction of Risk Potential
Nurse Bea should instruct the male client with an ileostomy to report immediately which of the following symptoms?CorrectIncorrect
Question 33 of 75
33. QuestionCategory: Physiological Adaptation
Jerry has been diagnosed with appendicitis. He develops a fever, hypotension, and tachycardia. The nurse suspects which of the following complications?CorrectIncorrect
Question 34 of 75
34. QuestionCategory: Physiological Adaptation
Which of the following complications should the nurse carefully monitor a client with acute pancreatitis?CorrectIncorrect
Question 35 of 75
35. QuestionCategory: Physiological Adaptation
Which of the following symptoms during the icteric phase of viral hepatitis should the nurse expect the client to inhibit?CorrectIncorrect
Question 36 of 75
36. QuestionCategory: Physiological Adaptation
Marco, who was diagnosed with a brain tumor, was scheduled for craniotomy. In preventing the development of cerebral edema after surgery, the nurse should expect the use of:CorrectIncorrect
Question 37 of 75
37. QuestionCategory: Pharmacological and Parenteral Therapies
Halfway through the administration of blood, the female client complains of lumbar pain. After stopping the infusion Nurse Hazel should:CorrectIncorrect
Question 38 of 75
38. QuestionCategory: Physiological Adaptation
Nurse Maureen knows that the positive diagnosis of HIV infection is made based on which of the following:CorrectIncorrect
Question 39 of 75
39. QuestionCategory: Health Promotion and Maintenance
Nurse Maureen is aware that a client who has been diagnosed with chronic renal failure recognizes an adequate amount of high-biological-value protein when the food the client selected from the menu was:CorrectIncorrect
Question 40 of 75
40. QuestionCategory: Physiological Adaptation
Kenneth, who was diagnosed with uremic syndrome has the potential to develop complications. Which among the following complications should the nurse anticipates:CorrectIncorrect
Question 41 of 75
41. QuestionCategory: Physiological Adaptation
A client is admitted to the hospital with benign prostatic hyperplasia, the nurse most relevant assessment would be:CorrectIncorrect
Question 42 of 75
42. QuestionCategory: Reduction of Risk Potential
A client has undergone a penile implant. After 24 hrs of surgery, the client’s scrotum was edematous and painful. The nurse should:CorrectIncorrect
Question 43 of 75
43. QuestionCategory: Physiological Adaptation
Nurse Hazel receives emergency laboratory results for a client with chest pain and immediately informs the physician. An increased myoglobin level suggests which of the following?CorrectIncorrect
Question 44 of 75
44. QuestionCategory: Physiological Adaptation
Nurse Maureen would expect a client with mitral stenosis would demonstrate symptoms associated with congestion in the:CorrectIncorrect
Question 45 of 75
45. QuestionCategory: Reduction of Risk Potential
A client has been diagnosed with hypertension. The nurse priority nursing diagnosis would be:CorrectIncorrect
Question 46 of 75
46. QuestionCategory: Pharmacological and Parenteral Therapies
Nurse Hazel teaches the client with angina about common expected side effects of nitroglycerin including:CorrectIncorrect
Question 47 of 75
47. QuestionCategory: Physiological Adaptation
The following are lipid abnormalities. Which of the following is a risk factor for the development of atherosclerosis and PVD?CorrectIncorrect
Question 48 of 75
48. QuestionCategory: Reduction of Risk Potential
Which of the following represents a significant risk immediately after surgery for repair of aortic aneurysm?CorrectIncorrect
Question 49 of 75
49. QuestionCategory: Basic Care and Comfort
Nurse Josie should instruct the client to eat which of the following foods to obtain the best supply of Vitamin B12?CorrectIncorrect
Question 50 of 75
50. QuestionCategory: Reduction of Risk Potential
Karen has been diagnosed with aplastic anemia. The nurse monitors for changes in which of the following physiologic functions?CorrectIncorrect
Question 51 of 75
51. QuestionCategory: Reduction of Risk Potential
Lydia is scheduled for elective splenectomy. Before the client goes to surgery, the nurse in charge final assessment would be:CorrectIncorrect
Question 52 of 75
52. QuestionCategory: Physiological Adaptation
What is the peak age range for acquiring acute lymphocytic leukemia (ALL)?CorrectIncorrect
Question 53 of 75
53. QuestionCategory: Physiological Adaptation
Marie with acute lymphocytic leukemia suffers from nausea and headache. These clinical manifestations may indicate all of the following except:CorrectIncorrect
Question 54 of 75
54. QuestionCategory: Reduction of Risk Potential
A client has been diagnosed with Disseminated Intravascular Coagulation (DIC). Which of the following is contraindicated with the client?CorrectIncorrect
Question 55 of 75
55. QuestionCategory: Physiological Adaptation
Which of the following findings is the best indication that fluid replacement for the client with hypovolemic shock is adequate?CorrectIncorrect
Question 56 of 75
56. QuestionCategory: Physiological Adaptation
Which of the following signs and symptoms would Nurse Maureen include in her teaching plan as an early manifestation of laryngeal cancer?CorrectIncorrect
Question 57 of 75
57. QuestionCategory: Physiological Adaptation
Karina, a client with myasthenia gravis, is to receive immunosuppressive therapy. The nurse understands that this therapy is effective because it:CorrectIncorrect
Question 58 of 75
58. QuestionCategory: Pharmacological and Parenteral Therapies
A female client is receiving IV Mannitol. An assessment specific to safe administration of the said drug is:CorrectIncorrect
Question 59 of 75
59. QuestionCategory: Health Promotion and Maintenance
Patricia, a 20-year-old college student with diabetes mellitus, requests additional information about the advantages of using a pen-like insulin delivery device. The nurse explains that the advantages of these devices over syringes include:CorrectIncorrect
Question 60 of 75
60. QuestionCategory: Reduction of Risk Potential
A male client’s left tibia was fractured in an automobile accident, and a cast is applied. To assess for damage to major blood vessels from the fracture tibia, the nurse in charge should monitor the client for:CorrectIncorrect
Question 61 of 75
61. QuestionCategory: Basic Care and Comfort
After a long leg cast is removed, the male client should:CorrectIncorrect
Question 62 of 75
62. QuestionCategory: Reduction of Risk Potential
While performing a physical assessment of a male client with gout of the great toe, Nurse Vivian should assess for additional tophi (urate deposits) on the:CorrectIncorrect
Question 63 of 75
63. QuestionCategory: Safety and Infection Control
Nurse Katrina would recognize that the demonstration of crutch walking with tripod gait was understood when the client places weight on the:CorrectIncorrect
Question 64 of 75
64. QuestionCategory: Physiological Adaptation
Mang Jose with rheumatoid arthritis states, “The only time I am without pain is when I lie in bed perfectly still”. During the convalescent stage, the nurse in charge with Mang Jose should encourage:CorrectIncorrect
Question 65 of 75
65. QuestionCategory: Reduction of Risk Potential
A male client has undergone spinal surgery, the nurse should:CorrectIncorrect
Question 66 of 75
66. QuestionCategory: Physiological Adaptation
Marina with acute renal failure moves into the diuretic phase after one week of therapy. During this phase the client must be assessed for signs of developing:CorrectIncorrect
Question 67 of 75
67. QuestionCategory: Reduction of Risk Potential
Nurse Judith obtains a specimen of clear nasal drainage from a client with a head injury. Which of the following tests differentiates mucus from cerebrospinal fluid (CSF)?CorrectIncorrect
Question 68 of 75
68. QuestionCategory: Physiological Adaptation
A 22-year-old client suffered from his first tonic-clonic seizure. Upon awakening, the client asks the nurse, “What caused me to have a seizure? Which of the following would the nurse include in the primary cause of tonic-clonic seizures in adults more than 20 years?CorrectIncorrect
Question 69 of 75
69. QuestionCategory: Reduction of Risk Potential
What is the priority nursing assessment in the first 24 hours after admission of the client with thrombotic CVA?CorrectIncorrect
Question 70 of 75
70. QuestionCategory: Health Promotion and Maintenance
Nurse Linda is preparing a client with multiple sclerosis for discharge from the hospital to home. Which of the following instructions is most appropriate?CorrectIncorrect
Question 71 of 75
71. QuestionCategory: Physiological Adaptation
The nurse is aware the early indicator of hypoxia in the unconscious client is:CorrectIncorrect
Question 72 of 75
72. QuestionCategory: Physiological Adaptation
A client is experiencing spinal shock. Nurse Myrna should expect the function of the bladder to be which of the following?CorrectIncorrect
Question 73 of 75
73. QuestionCategory: Physiological Adaptation
Which of the following stages is the carcinogen irreversible?CorrectIncorrect
Question 74 of 75
74. QuestionCategory: Physiological Adaptation
Among the following components thorough pain assessment, which is the most significant?CorrectIncorrect
Question 75 of 75
75. QuestionCategory: Physiological Adaptation
A 65 year old female is experiencing a flare-up of pruritus. Which of the client’s actions could aggravate the cause of flare-ups?CorrectIncorrect
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.
How to Register for the NCLEX?
So you’ve finally decided 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:
- 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.
- 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.
- 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.
- 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.
- 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.
- 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 a computer adaptive test (CAT), which reacts to your answers to determine your competence level. 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 the 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 can 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 the NCLEX covers a full spectrum of nursing activities. 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: 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:
|I. Safe and Effective Care Environment|
|Management of Care||17-23%|
|Safety and Infection Control||9-15%|
|II. Health Promotion and Maintenance||6-12%|
|III. Psychosocial Integrity||6-12%|
|IV. Physiological Integrity|
|Basic Care and Comfort||6-12%|
|Pharmacological and Parenteral Therapies||12-18%|
|Reduction of Risk Potential||9-15%|
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.
The Psychosocial Integrity category (6-12%) is content related to the promotion and support for the emotional, mental, and social well-being of the client experiencing stressful events and clients with acute or chronic mental illness.
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.
The maximum testing time for the NCLEX-RN is six (6) hours, and there is no time limit for each NCLEX question. The exam time includes all the tutorials and all the breaks. The first break is offered after two (2) hours, and 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 allotment to complete the examination.
How to Pass the NCLEX?
The NCSBN indicates that these three rules govern pass-or-fail decisions: 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.
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. You fail if you have not answered the minimum number of required questions. 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 number of questions you answer, you are given 15 experimental questions (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.
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
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.
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.
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.
For the video question format, you must 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
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 scoring 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.
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. You’ll be asked to perform a calculation in this question format 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.
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.
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 a trial run of 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.
Want more practice questions?
Please visit our Nursing Test Bank page if you’re looking to answer more practice questions from different topics and different question formats.
Recommended books and resources for your NCLEX success:
- Saunders Comprehensive Review for the NCLEX-RN (8th Edition)
The most comprehensive and complete NCLEX exam review book with over 5,200 NCLEX-style questions that are thoroughly updated to reflect the most recent test plan.
- Saunders Q & A Review for the NCLEX-RN® Examination (8th Edition)
This popular review offers more than 6,000 test questions, giving you all the Q&A practice you need to pass the NCLEX-RN examination! Each question enhances review by including a test-taking strategy and rationale for correct and incorrect answers.
- NCLEX-RN Prep Plus by Kaplan (24th Edition)
Kaplan’s NCLEX-RN Prep Plus uses expert critical thinking strategies and targeted sample questions to help you put your expertise into practice and face the exam with confidence.
- Illustrated Study Guide for the NCLEX-RN Exam
Using colorful illustrations and fun mnemonic cartoons, the Illustrated Study Guide for the NCLEX-RN® Exam, 10th Edition brings the concepts found on the NCLEX-RN to life!
- NCLEX RN Examination Prep Flashcards
Easy to use flash cards developed by test prep books for test takers trying to achieve a passing score on the NCLEX RN test, these flashcards cover.
- Prioritization, Delegation, and Assignment: Practice Exercises for the NCLEX-RN Examination
This book is the first and the most popular NCLEX-RN Exam review book focused exclusively on building management-of-care clinical judgment skills.
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The book includes a review of all nursing content areas, more than 4,500 NCLEX exam-style questions, detailed rationales, test-taking tips and strategies, and new Next-Generation NCLEX (NGN)-style questions.
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