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.
Looking for the complete collection of practice questions?
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 #7: 75 Questions
Sharpen your critical thinking skills and nursing knowledge with these new set of practice questions for the NCLEX-RN.
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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: Health Promotion and Maintenance
The nurse is providing discharge teaching for the client with leukemia. The client should be told to avoid:CorrectIncorrect
Question 2 of 75
2. QuestionCategory: Reduction of Risk Potential
The nurse is changing the ties of the client with a tracheostomy. The safest method of changing the tracheostomy ties is to:CorrectIncorrect
Question 3 of 75
3. QuestionCategory: Reduction of Risk Potential
The nurse is monitoring a client following a lung resection. The hourly output from the chest tube was 300mL. The nurse should give priority to:CorrectIncorrect
Question 4 of 75
4. QuestionCategory: Pharmacological and Parenteral Therapies
The infant is admitted to the unit with tetralogy of fallot. The nurse would anticipate an order for which medication?CorrectIncorrect
Question 5 of 75
5. QuestionCategory: Health Promotion and Maintenance
The nurse is educating the lady’s club in a self-breast exam. The nurse is aware that most malignant breast masses occur in the Tail of Spence.
On the diagram below, select where the Tail of Spence is.CorrectIncorrect
Question 6 of 75
The toddler is admitted with a cardiac anomaly. The nurse is aware that the infant with a ventricular septal defect will:CorrectIncorrect
Question 7 of 75
7. QuestionCategory: Reduction of Risk Potential
The nurse is monitoring a client with a history of stillborn infants. The nurse is aware that a nonstress test can be ordered for this client to:CorrectIncorrect
Question 8 of 75
8. QuestionCategory: Health Promotion and Maintenance
The nurse is evaluating the client who was admitted 8 hours ago for induction of labor. The following graph is noted on the monitor. Which action should be taken first by the nurse?CorrectIncorrect
Question 9 of 75
9. QuestionCategory: Reduction of Risk Potential
The nurse notes the following on the ECG monitor. The nurse would evaluate the cardiac arrhythmia as:CorrectIncorrect
Question 10 of 75
A client with clotting disorder has an order to continue lovenox (Enoxaparin) injections after discharge. The nurse should teach the client that lovenox injections should:CorrectIncorrect
Question 11 of 75
11. QuestionCategory: Pharmacological and Parenteral Therapies
The nurse has a preop order to administer valium (Diazepam) 10mg and phenergan (Promethazine) 25mg. The correct method of administering these medications is to:CorrectIncorrect
Question 12 of 75
12. QuestionCategory: Health Promotion and Maintenance
A client with frequent urinary tract infections asks the nurse how she can prevent the recurrence. The nurse should teach the client to:CorrectIncorrect
Question 13 of 75
13. QuestionCategory: Management of Care
Which task should be assigned to the nursing assistant?CorrectIncorrect
Question 14 of 75
14. QuestionCategory: Reduction of Risk Potential
The client has recently returned from having a thyroidectomy. The nurse should keep which of the following at the bedside?CorrectIncorrect
Question 15 of 75
15. QuestionCategory: Physiological Adaptation
The physician has ordered a histoplasmosis test for the elderly client. The nurse is aware that histoplasmosis is transmitted to humans by:CorrectIncorrect
Question 16 of 75
16. QuestionCategory: Physiological Adaptation
What’s the first intervention for a patient experiencing chest pain and a p02 of 89%?CorrectIncorrect
Question 17 of 75
17. QuestionCategory: Physiological Adaptation
Which of the following signs and symptoms usually signifies rapid expansion and impending rupture of an abdominal aortic aneurysm?CorrectIncorrect
Question 18 of 75
18. QuestionCategory: Physiological Adaptation
In which of the following types of cardiomyopathy does cardiac output remain normal?CorrectIncorrect
Question 19 of 75
19. QuestionCategory: Physiological Adaptation
Which of the following interventions should be your first priority when treating a patient experiencing chest pain while walking?CorrectIncorrect
Question 20 of 75
20. QuestionCategory: Physiological Adaptation
Which of the following positions would best aid breathing for a patient with acute pulmonary edema?CorrectIncorrect
Question 21 of 75
21. QuestionCategory: Reduction of Risk Potential
A pregnant woman arrives at the emergency department (ED) with abruptio placentae at 34 weeks’ gestation. She’s at risk for which of the following blood dyscrasias?CorrectIncorrect
Question 22 of 75
22. QuestionCategory: Physiological Adaptation
A 16-year-old patient involved in a motor vehicle accident arrives in the ED unconscious and severely hypotensive. He’s suspected to have several fractures of his pelvis and legs. Which of the following parenteral fluids is the best choice for his current condition?CorrectIncorrect
Question 23 of 75
23. QuestionCategory: Pharmacological and Parenteral Therapies
Corticosteroids are potent suppressors of the body’s inflammatory response. Which of the following conditions or actions do they suppress?CorrectIncorrect
Question 24 of 75
24. QuestionCategory: Pharmacological and Parenteral Therapies
A patient infected with human immunodeficiency virus (HIV) begins zidovudine therapy. Which of the following statements best describes this drug’s action?CorrectIncorrect
Question 25 of 75
25. QuestionCategory: Basic Care and Comfort
A 20-year-old patient is being treated for pneumonia. He has a persistent cough and complains of severe pain on coughing. What could you tell him to help him reduce his discomfort?CorrectIncorrect
Question 26 of 75
26. QuestionCategory: Physiological Adaptation
A 19-year-old patient comes to the ED with acute asthma. His respiratory rate is 44 breaths/minute, and he appears to be in acute respiratory distress. Which of the following actions should you take first?CorrectIncorrect
Question 27 of 75
27. QuestionCategory: Physiological Adaptation
A firefighter who was involved in extinguishing a house fire is being treated for smoke inhalation. He developed severe hypoxia 48 hours after the incident, requiring intubation and mechanical ventilation. Which of the following conditions has he most likely developed?CorrectIncorrect
Question 28 of 75
28. QuestionCategory: Reduction of Risk Potential
Which of the following measures best determines that a patient who had a pneumothorax no longer needs a chest tube?CorrectIncorrect
Question 29 of 75
29. QuestionCategory: Physiological Adaptation
Which of the following nursing interventions should you use to prevent footdrop and contractures in a patient recovering from a subdural hematoma?CorrectIncorrect
Question 30 of 75
30. QuestionCategory: Physiological Adaptation
Which of the following signs of increased intracranial pressure (ICP) would appear first after head trauma?CorrectIncorrect
Question 31 of 75
31. QuestionCategory: Physiological Adaptation
When giving intravenous (I.V.) phenytoin, which of the following methods should you use?CorrectIncorrect
Question 32 of 75
32. QuestionCategory: Physiological Adaptation
After surgical repair of a hip, which of the following positions is best for the patient’s legs and hips?CorrectIncorrect
Question 33 of 75
33. QuestionCategory: Physiological Adaptation
Which of the following factors should be the primary focus of nursing management in a patient with acute pancreatitis?CorrectIncorrect
Question 34 of 75
34. QuestionCategory: Reduction of Risk Potential
After a liver biopsy, place the patient in which of the following positions?CorrectIncorrect
Question 35 of 75
35. QuestionCategory: Reduction of Risk Potential
Which of the following potentially serious complications could occur with therapy for hypothyroidism?CorrectIncorrect
Question 36 of 75
36. QuestionCategory: Physiological Adaptation
Adequate fluid replacement and vasopressin replacement are objectives of therapy for which of the following disease processes? Adequate fluid replacement and vasopressin replacement are objectives of therapy for which of the following disease processes?CorrectIncorrect
Question 37 of 75
37. QuestionCategory: Physiological Adaptation
Patients with Type 1 diabetes mellitus may require which of the following changes to their daily routine during periods of infection?CorrectIncorrect
Question 38 of 75
38. QuestionCategory: Reduction of Risk Potential
On a follow-up visit after having a vaginal hysterectomy, a 32-year-old patient has a decreased hematocrit level. Which of the following complications does this suggest?CorrectIncorrect
Question 39 of 75
39. QuestionCategory: Pharmacological and Parenteral Therapies
A patient has partial-thickness burns to both legs and portions of his trunk. Which of the following I.V. fluids are given first?CorrectIncorrect
Question 40 of 75
40. QuestionCategory: Health Promotion and Maintenance
Which of the following techniques is correct for obtaining a wound culture specimen from a surgical site?CorrectIncorrect
Question 41 of 75
41. QuestionCategory: Pharmacological and Parenteral Therapies
A nurse is administering IV furosemide to a patient admitted with congestive heart failure. After the infusion, which of the following symptoms is not expected?CorrectIncorrect
Question 42 of 75
42. QuestionCategory: Health Promotion and Maintenance
There are a number of risk factors associated with coronary artery disease. Which of the following is a modifiable risk factor?CorrectIncorrect
Question 43 of 75
43. QuestionCategory: Physiological Adaptation
Tissue plasminogen activator (t-PA) is considered for the treatment of a patient who arrives in the emergency department following the onset of symptoms of myocardial infarction. Which of the following is a contraindication for treatment with t-PA?CorrectIncorrect
Question 44 of 75
44. QuestionCategory: Health Promotion and Maintenance
Following myocardial infarction, a hospitalized patient is encouraged to practice frequent leg exercises and ambulate in the hallway as directed by his physician. Which of the following choices reflects the purpose of exercise for this patient?CorrectIncorrect
Question 45 of 75
45. QuestionCategory: Physiological Adaptation
A patient arrives in the emergency department with symptoms of myocardial infarction, progressing to cardiogenic shock. Which of the following symptoms should the nurse expect the patient to exhibit with cardiogenic shock?CorrectIncorrect
Question 46 of 75
46. QuestionCategory: Physiological Adaptation
A patient with a history of congestive heart failure arrives at the clinic complaining of dyspnea. Which of the following actions is the first the nurse should perform?CorrectIncorrect
Question 47 of 75
47. QuestionCategory: Pharmacological and Parenteral Therapies
A clinic patient has recently been prescribed nitroglycerin for treatment of angina. He calls the nurse complaining of frequent headaches. Which of the following responses to the patient is correct?CorrectIncorrect
Question 48 of 75
48. QuestionCategory: Reduction of Risk Potential
A patient received surgery and chemotherapy for colon cancer, completing therapy three (3) months previously, and she is now in remission. At a follow-up appointment, she complains of fatigue following activity and difficulty with concentration at her weekly bridge games. Which of the following explanations would account for her symptoms?CorrectIncorrect
Question 49 of 75
49. QuestionCategory: Basic Care and Comfort
A clinic patient has a hemoglobin concentration of 10.8 g/dL and reports sticking to a strict vegetarian diet. Which of the following nutritional advice is appropriate?CorrectIncorrect
Question 50 of 75
50. QuestionCategory: Physiological Adaptation
A hospitalized patient is receiving packed red blood cells (PRBCs) for treatment of severe anemia. Which of the following is the most accurate statement?CorrectIncorrect
Question 51 of 75
51. QuestionCategory: Reduction of Risk Potential
A patient who has received chemotherapy for cancer treatment is given an injection of Epoetin. Which of the following should reflect the findings in a complete blood count (CBC) drawn several days later?CorrectIncorrect
Question 52 of 75
A patient is admitted to the hospital with suspected polycythemia vera. Which of the following symptoms is consistent with the diagnosis? Select all that apply.CorrectIncorrect
Question 53 of 75
53. QuestionCategory: Reduction of Risk Potential
A nurse is caring for a patient with a platelet count of 20,000/microliter. Which of the following is an important intervention?CorrectIncorrect
Question 54 of 75
54. QuestionCategory: Pharmacological and Parenteral Therapies
A nurse in the emergency department assesses a patient who has been taking long-term corticosteroids to treat renal disease. Which of the following is a typical side effect of corticosteroid treatment? Select all that apply.CorrectIncorrect
Question 55 of 75
55. QuestionCategory: Physiological Adaptation
A nurse is caring for patients in the oncology unit. Which of the following is the most important nursing action when caring for a neutropenic patient?CorrectIncorrect
Question 56 of 75
56. QuestionCategory: Health Promotion and Maintenance
A patient is undergoing the induction stage of treatment for leukemia. The nurse teaches family members about infectious precautions. Which of the following statements by family members indicates that the family needs more education?CorrectIncorrect
Question 57 of 75
57. QuestionCategory: Health Promotion and Maintenance
A nurse is caring for a patient with acute lymphoblastic leukemia (ALL). Which of the following is the most likely age range of the patient?CorrectIncorrect
Question 58 of 75
58. QuestionCategory: Physiological Adaptation
A patient is admitted to the oncology unit for diagnosis of suspected Hodgkin’s disease. Which of the following symptoms is typical of Hodgkin’s disease?CorrectIncorrect
Question 59 of 75
59. QuestionCategory: Physiological Adaptation
The Hodgkin’s disease patient described in the question above undergoes a lymph node biopsy for definitive diagnosis. If the diagnosis of Hodgkin’s disease were correct, which of the following cells would the pathologist expect to find?CorrectIncorrect
Question 60 of 75
60. QuestionCategory: Physiological Adaptation
A patient is about to undergo bone marrow aspiration and biopsy and expresses fear and anxiety about the procedure. Which of the following is the most effective nursing response?CorrectIncorrect
Question 61 of 75
61. QuestionCategory: Reduction of Risk Potential
A 43-year-old African American male is admitted with sickle cell anemia. The nurse plans to assess circulation in the lower extremities every 2 hours. Which of the following outcome criteria would the nurse use?CorrectIncorrect
Question 62 of 75
62. QuestionCategory: Physiological Adaptation
A 30-year-old male from Haiti is brought to the emergency department in sickle cell crisis. What is the best position for this client?CorrectIncorrect
Question 63 of 75
63. QuestionCategory: Physiological Adaptation
A 25-year-old male is admitted in sickle cell crisis. Which of the following interventions would be of the highest priority for this client?CorrectIncorrect
Question 64 of 75
64. QuestionCategory: Basic Care and Comfort
Which of the following foods would the nurse encourage the client in sickle cell crisis to eat?CorrectIncorrect
Question 65 of 75
65. QuestionCategory: Physiological Adaptation
A newly admitted client has a sickle cell crisis. The nurse is planning care based on the assessment of the client. The client is complaining of severe pain in his feet and hands. The pulse oximetry is 92. Which of the following interventions would be implemented first? Assume that there are orders for each intervention.CorrectIncorrect
Question 66 of 75
66. QuestionCategory: Basic Care and Comfort
The nurse is instructing a client with iron-deficiency anemia. Which of the following meal plans would the nurse expect the client to select?CorrectIncorrect
Question 67 of 75
67. QuestionCategory: Health Promotion and Maintenance
Clients with sickle cell anemia are taught to avoid activities that cause hypoxia and hypoxemia. Which of the following activities would the nurse recommend?CorrectIncorrect
Question 68 of 75
68. QuestionCategory: Physiological Adaptation
The nurse is conducting an admission assessment of a client with vitamin B12 deficiency. Which of the following would the nurse include in the physical assessment?CorrectIncorrect
Question 69 of 75
69. QuestionCategory: Health Promotion and Maintenance
An African American female comes to the outpatient clinic. The physician suspects vitamin B12 deficiency anemia. Because jaundice is often a clinical manifestation of this type of anemia, what body part would be the best indicator?CorrectIncorrect
Question 70 of 75
70. QuestionCategory: Physiological Adaptation
The nurse is conducting a physical assessment on a client with anemia. Which of the following clinical manifestations would be most indicative of the anemia?CorrectIncorrect
Question 71 of 75
71. QuestionCategory: Health Promotion and Maintenance
The nurse is teaching the client with polycythemia vera about prevention of complications of the disease. Which of the following statements by the client indicates a need for further teaching?CorrectIncorrect
Question 72 of 75
72. QuestionCategory: Health Promotion and Maintenance
A 33-year-old male is being evaluated for possible acute leukemia. Which of the following would the nurse inquire about as a part of the assessment?CorrectIncorrect
Question 73 of 75
73. QuestionCategory: Health Promotion and Maintenance
An African American client is admitted with acute leukemia. The nurse is assessing for signs and symptoms of bleeding. Where is the best site for examining for the presence of petechiae?CorrectIncorrect
Question 74 of 75
74. QuestionCategory: Health Promotion and Maintenance
A client with acute leukemia is admitted to the oncology unit. Which of the following would be most important for the nurse to inquire?CorrectIncorrect
Question 75 of 75
75. QuestionCategory: Reduction of Risk Potential
Which of the following would be the priority nursing diagnosis for the adult client with acute leukemia?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.
- 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.