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 #4: 75 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: Management of Care
Which action(s) should you delegate to the experienced nursing assistant when caring for a patient with a thrombotic stroke with residual left-sided weakness? Select all that apply.CorrectIncorrect
Question 2 of 75
2. QuestionCategory: Management of Care
The patient who had a stroke needs to be fed. What instruction should you give to the nursing assistant who will feed the patient?CorrectIncorrect
Question 3 of 75
3. QuestionCategory: Physiological Adaptation
You have just admitted a patient with bacterial meningitis to the medical-surgical unit. The patient complains of a severe headache with photophobia and has a temperature of 102.60 F orally. Which collaborative intervention must be accomplished first?CorrectIncorrect
Question 4 of 75
4. QuestionCategory: Management of Care
You are mentoring a student nurse in the intensive care unit (ICU) while caring for a patient with meningococcal meningitis. Which action by the student requires that you intervene immediately?CorrectIncorrect
Question 5 of 75
5. QuestionCategory: Management of Care
A 23-year-old patient with a recent history of encephalitis is admitted to the medical unit with new-onset generalized tonic-clonic seizures. Which nursing activities included in the patient’s care will be best to delegate to an LPN/LVN whom you are supervising? Select all that apply.CorrectIncorrect
Question 6 of 75
6. QuestionCategory: Physiological Adaptation
While working in the ICU, you are assigned to care for a patient with a seizure disorder. Which of these nursing actions will you implement first if the patient has a seizure?CorrectIncorrect
Question 7 of 75
7. QuestionCategory: Pharmacological and Parenteral Therapies
A patient recently started on phenytoin (Dilantin) to control simple complex seizures is seen in the outpatient clinic. Which information obtained during his chart review and assessment will be of greatest concern?CorrectIncorrect
Question 8 of 75
8. QuestionCategory: Management of Care
After receiving a change-of-shift report at 7:00 AM, which of these patients will you assess first?CorrectIncorrect
Question 9 of 75
9. QuestionCategory: Management of Care
All of these nursing activities are included in the care plan for a 78-year-old man with Parkinson’s disease who has been referred to your home health agency. Which ones will you delegate to a nursing assistant (NA)? Select all that apply.CorrectIncorrect
Question 10 of 75
10. QuestionCategory: Management of Care
As the manager in a long-term-care (LTC) facility, you are in charge of developing a standard plan of care for residents with Alzheimer’s disease. Which of these nursing tasks is best to delegate to the LPN team leaders working in the facility?CorrectIncorrect
Question 11 of 75
11. QuestionCategory: Basic Care and Comfort
An 89-year-old female patient who has been admitted to the medical unit with new-onset angina also has a diagnosis of Alzheimer’s disease. The patient’s husband reports to you that he rarely gets a good night’s sleep because he needs to make sure his wife does not wander during the night. He insists on checking each of the medications you give her to be sure they are the same as the ones she takes at home. Based on this information, which nursing diagnosis is most appropriate for this patient?CorrectIncorrect
Question 12 of 75
12. QuestionCategory: Pharmacological and Parenteral Therapies
You are caring for a patient with recurrent glioblastoma who is receiving dexamethasone (Decadron) 4 mg IV every 6 hours to relieve symptoms of right arm weakness and headache. Which assessment information concerns you the most?CorrectIncorrect
Question 13 of 75
13. QuestionCategory: Management of Care
A 70-year-old alcoholic patient with acute lethargy, confusion, and incontinence is admitted to the hospital ED. His wife tells you that he fell down the stairs about a month ago, but “he didn’t have a scratch afterward.” She feels that he has become gradually less active and sleepier over the last 10 days or so. Which of the following collaborative interventions will you implement first?CorrectIncorrect
Question 14 of 75
14. QuestionCategory: Management of Care
Which of these patients in the neurologic ICU will be best to assign to an RN who has floated from the medical unit?CorrectIncorrect
Question 15 of 75
15. QuestionCategory: Physiological Adaptation
What is the priority nursing diagnosis for a patient experiencing a migraine headache?CorrectIncorrect
Question 16 of 75
16. QuestionCategory: Reduction of Risk Potential
Nurse Michelle should know that the drainage is normal four (4) days after a sigmoid colostomy when the stool is:CorrectIncorrect
Question 17 of 75
17. QuestionCategory: Physiological Adaptation
Where would nurse Kristine place the call light for a male client with a right-sided brain attack and left homonymous hemianopsia?CorrectIncorrect
Question 18 of 75
18. QuestionCategory: Physiological Adaptation
A male client is admitted to the emergency department following an accident. What are the first nursing actions of the nurse?CorrectIncorrect
Question 19 of 75
19. QuestionCategory: Pharmacological and Parenteral Therapies
In evaluating the effect of nitroglycerin, Nurse Arthur should know that it reduces preload and relieves angina by:CorrectIncorrect
Question 20 of 75
20. QuestionCategory: Physiological Adaptation
Nurse Patricia finds a female client who is post-myocardial infarction (MI) slumped on the side rails of the bed and unresponsive to shaking or shouting. Which is the nurse’s next action?CorrectIncorrect
Question 21 of 75
21. QuestionCategory: Physiological Adaptation
Nurse Monett is caring for a client recovering from gastrointestinal bleeding. The nurse should:CorrectIncorrect
Question 22 of 75
22. QuestionCategory: Pharmacological and Parenteral Therapies
A male client was on warfarin (Coumadin) before admission and has been receiving heparin I.V. for 2 days. The partial thromboplastin time (PTT) is 68 seconds. What should Nurse Carla do?CorrectIncorrect
Question 23 of 75
23. QuestionCategory: Physiological Adaptation
A client underwent ileostomy, when should the drainage appliance be applied to the stoma?CorrectIncorrect
Question 24 of 75
24. QuestionCategory: Reduction of Risk Potential
A client has undergone spinal anesthetic, it will be important that the nurse immediately position the client in:CorrectIncorrect
Question 25 of 75
25. QuestionCategory: Physiological Adaptation
While monitoring a male client several hours after a motor vehicle accident, which assessment data suggest increasing intracranial pressure?CorrectIncorrect
Question 26 of 75
26. QuestionCategory: Physiological Adaptation
Mrs. Cruz, 80 years old is diagnosed with pneumonia. Which of the following symptoms may appear first?CorrectIncorrect
Question 27 of 75
27. QuestionCategory: Physiological Adaptation
A male client has active tuberculosis (TB). Which of the following symptoms will be exhibited?CorrectIncorrect
Question 28 of 75
28. QuestionCategory: Physiological Adaptation
Mark, a 7-year-old client, is brought to the emergency department. He’s tachypneic and afebrile and has a respiratory rate of 36 breaths/minute and has a nonproductive cough. He recently had a cold. Form this history; the client may have which of the following conditions?CorrectIncorrect
Question 29 of 75
29. QuestionCategory: Pharmacological and Parenteral Therapies
Marichu was given morphine sulfate for pain. She is sleeping and her respiratory rate is 4 breaths/minute. If action isn’t taken quickly, she might have which of the following reactions?CorrectIncorrect
Question 30 of 75
30. QuestionCategory: Health Promotion and Maintenance
A 77-year-old male client is admitted for elective knee surgery. Physical examination reveals shallow respirations but no sign of respiratory distress. Which of the following is a normal physiologic change related to aging?CorrectIncorrect
Question 31 of 75
31. QuestionCategory: Pharmacological and Parenteral Therapies
Nurse John is caring for a male client receiving lidocaine I.V. Which factor is the most relevant to the administration of this medication?CorrectIncorrect
Question 32 of 75
32. QuestionCategory: Pharmacological and Parenteral Therapies
Nurse Ron is caring for a male client taking an anticoagulant. The nurse should teach the client to:CorrectIncorrect
Question 33 of 75
33. QuestionCategory: Reduction of Risk Potential
Nurse Lynette is preparing a site for the insertion of an I.V. catheter. The nurse should treat excess hair at the site by:CorrectIncorrect
Question 34 of 75
34. QuestionCategory: Health Promotion and Maintenance
Nurse Michelle is caring for an elderly female with osteoporosis. When teaching the client, the nurse should include information about which major complication:CorrectIncorrect
Question 35 of 75
35. QuestionCategory: Health Promotion and Maintenance
Nurse Len is teaching a group of women to perform BSE. The nurse should explain that the purpose of performing the examination is to discover:CorrectIncorrect
Question 36 of 75
36. QuestionCategory: Basic Care and Comfort
When caring for a female client who is being treated for hyperthyroidism, it is important to:CorrectIncorrect
Question 37 of 75
37. QuestionCategory: Health Promotion and Maintenance
Nurse Kris is teaching a client with a history of atherosclerosis. To decrease the risk of atherosclerosis, the nurse should encourage the client to:CorrectIncorrect
Question 38 of 75
38. QuestionCategory: Physiological Adaptation
Nurse Greta is working on a surgical floor. Nurse Greta must logroll a client following a:CorrectIncorrect
Question 39 of 75
39. QuestionCategory: Health Promotion and Maintenance
A 55-year old client underwent cataract removal with intraocular lens implant. Nurse Oliver is giving the client discharge instructions. These instructions should include which of the following?CorrectIncorrect
Question 40 of 75
40. QuestionCategory: Health Promotion and Maintenance
George should be taught about testicular examinations during:CorrectIncorrect
Question 41 of 75
41. QuestionCategory: Physiological Adaptation
A male client has undergone a colon resection. While turning him, wound dehiscence with evisceration occurs. Nurse Trish first response is to:CorrectIncorrect
Question 42 of 75
42. QuestionCategory: Physiological Adaptation
Nurse Audrey is caring for a client who has suffered a severe cerebrovascular accident. During routine assessment, the nurse notices Cheyne- Stokes respirations. Cheyne-stokes respirations are:CorrectIncorrect
Question 43 of 75
43. QuestionCategory: Physiological Adaptation
Nurse Bea is assessing a male client with heart failure. The breath sounds commonly auscultated in clients with heart failure are:CorrectIncorrect
Question 44 of 75
44. QuestionCategory: Physiological Adaptation
The nurse is caring for Kenneth experiencing an acute asthma attack. The client stops wheezing and breath sounds aren’t audible. The reason for this change is that:CorrectIncorrect
Question 45 of 75
45. QuestionCategory: Safety and Infection Control
Mike with epilepsy is having a seizure. During the active seizure phase, the nurse should:CorrectIncorrect
Question 46 of 75
46. QuestionCategory: Reduction of Risk Potential
After insertion of a chest tube for a pneumothorax, a client becomes hypotensive with neck vein distention, tracheal shift, absent breath sounds, and diaphoresis. Nurse Amanda suspects a tension pneumothorax has occurred. What cause of tension pneumothorax should the nurse check for?CorrectIncorrect
Question 47 of 75
47. QuestionCategory: Safety and Infection Control
Nurse Maureen is talking to a male client, the client begins choking on his lunch. He’s coughing forcefully. The nurse should:CorrectIncorrect
Question 48 of 75
48. QuestionCategory: Health Promotion and Maintenance
Nurse Ron is taking the health history of an 84-year-old client. Which information will be most useful to the nurse for planning care?CorrectIncorrect
Question 49 of 75
49. QuestionCategory: Physiological Adaptation
When performing oral care on a comatose client, Nurse Krina should:CorrectIncorrect
Question 50 of 75
50. QuestionCategory: Physiological Adaptation
A 77-year-old male client is admitted with a diagnosis of dehydration and change in mental status. He’s being hydrated with I.V. fluids. When the nurse takes his vital signs, she notes he has a fever of 103°F (39.4°C) a cough producing yellow sputum and pleuritic chest pain. The nurse suspects this client may have which of the following conditions?CorrectIncorrect
Question 51 of 75
51. QuestionCategory: Health Promotion and Maintenance
Nurse Oliver is working in an outpatient clinic. He has been alerted that there is an outbreak of tuberculosis (TB). Which of the following clients entering the clinic today is most likely to have TB?CorrectIncorrect
Question 52 of 75
52. QuestionCategory: Reduction of Risk Potential
Virgie with a positive Mantoux test result will be sent for a chest X-ray. The nurse is aware that which of the following reasons this is done?CorrectIncorrect
Question 53 of 75
53. QuestionCategory: Physiological Adaptation
Kennedy with acute asthma showing inspiratory and expiratory wheezes and a decreased forced expiratory volume should be treated with which of the following classes of medication right away?CorrectIncorrect
Question 54 of 75
54. QuestionCategory: Physiological Adaptation
Mr. Vasquez 56-year-old client with a 40-year history of smoking one to two packs of cigarettes per day has a chronic cough producing thick sputum, peripheral edema, and cyanotic nail beds. Based on this information, he most likely has which of the following conditions?CorrectIncorrect
Question 55 of 75
55. QuestionCategory: Reduction of Risk Potential
Situation: Francis, age 46 is admitted to the hospital with a diagnosis of Chronic Lymphocytic Leukemia. The treatment for patients with leukemia is bone marrow transplantation. Which statement about bone marrow transplantation is not correct?CorrectIncorrect
Question 56 of 75
56. QuestionCategory: Safety and Infection Control
After several days of admission, Francis becomes disoriented and complains of frequent headaches. The nurse in-charge first action would be:CorrectIncorrect
Question 57 of 75
57. QuestionCategory: Physiological Adaptation
During routine care, Francis asks the nurse, “How can I be anemic if this disease causes increased white blood cell production?” The nurse in-charge best response would be that the increased number of white blood cells (WBC) is:CorrectIncorrect
Question 58 of 75
58. QuestionCategory: Reduction of Risk Potential
Diagnostic assessment of Francis would probably not reveal:CorrectIncorrect
Question 59 of 75
59. QuestionCategory: Reduction of Risk Potential
Robert, a 57-year-old client with acute arterial occlusion of the left leg undergoes an emergency embolectomy. Six hours later, the nurse isn’t able to obtain pulses in his left foot using Doppler ultrasound. The nurse immediately notifies the physician and asks her to prepare the client for surgery. As the nurse enters the client’s room to prepare him, he states that he won’t have any more surgery. Which of the following is the best initial response by the nurse?CorrectIncorrect
Question 60 of 75
60. QuestionCategory: Management of Care
During the endorsement, which of the following clients should the on-duty nurse assess first?CorrectIncorrect
Question 61 of 75
61. QuestionCategory: Pharmacological and Parenteral Therapies
Honey, a 23-year old client complains of substernal chest pain and states that her heart feels like “it’s racing out of the chest”. She reports no history of cardiac disorders. The nurse attaches her to a cardiac monitor and notes sinus tachycardia with a rate of 136beats/minutes. Breath sounds are clear and the respiratory rate is 26 breaths/minutes. Which of the following drugs should the nurse question the client about using?CorrectIncorrect
Question 62 of 75
62. QuestionCategory: Health Promotion and Maintenance
A 51-year-old female client tells the nurse-in-charge that she has found a painless lump in her right breast during her monthly self-examination. Which assessment finding would strongly suggest that this client’s lump is cancerous?CorrectIncorrect
Question 63 of 75
63. QuestionCategory: Physiological Adaptation
A 35-year-old client with vaginal cancer asks the nurse, “What is the usual treatment for this type of cancer?” Which treatment should the nurse name?CorrectIncorrect
Question 64 of 75
64. QuestionCategory: Reduction of Risk Potential
Cristina undergoes a biopsy of a suspicious lesion. The biopsy report classifies the lesion according to the TNM staging system as follows: TIS, N0, M0. What does this classification mean?CorrectIncorrect
Question 65 of 75
65. QuestionCategory: Reduction of Risk Potential
Lydia undergoes a laryngectomy to treat laryngeal cancer. When teaching the client how to care for the neck stoma, the nurse should include which instruction?CorrectIncorrect
Question 66 of 75
66. QuestionCategory: Physiological Adaptation
A 37-year-old client with uterine cancer asks the nurse, “Which is the most common type of cancer in women?” The nurse replies that it’s breast cancer. Which type of cancer causes the most deaths in women?CorrectIncorrect
Question 67 of 75
67. QuestionCategory: Physiological Adaptation
Antonio with lung cancer develops Horner’s syndrome when the tumor invades the ribs and affects the sympathetic nerve ganglia. When assessing for signs and symptoms of this syndrome, the nurse should note:CorrectIncorrect
Question 68 of 75
68. QuestionCategory: Reduction of Risk Potential
Vic asks the nurse what PSA is. The nurse should reply that it stands for:CorrectIncorrect
Question 69 of 75
69. QuestionCategory: Reduction of Risk Potential
What is the most important postoperative instruction that nurse Kate must give a client who has just returned from the operating room after receiving a subarachnoid block?CorrectIncorrect
Question 70 of 75
70. QuestionCategory: Reduction of Risk Potential
A male client suspected of having colorectal cancer will require which diagnostic study to confirm the diagnosis?CorrectIncorrect
Question 71 of 75
71. QuestionCategory: Physiological Adaptation
During a breast examination, which finding most strongly suggests that the Luz has breast cancer?CorrectIncorrect
Question 72 of 75
72. QuestionCategory: Physiological Adaptation
A female client with cancer is being evaluated for possible metastasis. Which of the following is one of the most common metastasis sites for cancer cells?CorrectIncorrect
Question 73 of 75
73. QuestionCategory: Reduction of Risk Potential
Nurse Mandy is preparing a client for magnetic resonance imaging (MRI) to confirm or rule out a spinal cord lesion. During the MRI scan, which of the following would pose a threat to the client?CorrectIncorrect
Question 74 of 75
74. QuestionCategory: Health Promotion and Maintenance
Nurse Cecile is teaching a female client about preventing osteoporosis. Which of the following teaching points is correct?CorrectIncorrect
Question 75 of 75
75. QuestionCategory: Reduction of Risk Potential
Before Jacob undergoes arthroscopy, the nurse reviews the assessment findings for contraindications for this procedure. Which finding is a contraindication?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:
|Safe and Effective Care Environment|
|Management of Care||17-23%|
|Safety and Infection Control||9-15%|
|Health Promotion and Maintenance||6-12%|
|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 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.
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.
- Saunders Comprehensive Review for the NCLEX-PN Examination (8th Edition)
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.
- More NCLEX review books here.