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 #8: 75 Questions
A new set of 75-item questions (now part 8 of the series)!
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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 Integrity
A 21-year-old male with Hodgkin’s lymphoma is a senior at the local university. He is engaged to be married and is to begin a new job upon graduation. Which of the following diagnoses would be a priority for this client?CorrectIncorrect
Question 2 of 75
2. QuestionCategory: Physiological Integrity
A client has autoimmune thrombocytopenic purpura. To determine the client’s response to treatment, the nurse would monitor:CorrectIncorrect
Question 3 of 75
3. QuestionCategory: Physiological Integrity
The home health nurse is visiting a client with autoimmune thrombocytopenic purpura (ATP). The client’s platelet count currently is 80, it will be most important to teach the client and family about:CorrectIncorrect
Question 4 of 75
4. QuestionCategory: Physiological Integrity
A client with a pituitary tumor has had transsphenoidal hypophysectomy. Which of the following interventions would be appropriate for this client?CorrectIncorrect
Question 5 of 75
5. QuestionCategory: Physiological Integrity
The client with a history of diabetes insipidus is admitted with polyuria, polydipsia, and mental confusion. The priority intervention for this client is:CorrectIncorrect
Question 6 of 75
A client with hemophilia has a nosebleed. Which nursing action is most appropriate to control the bleeding?CorrectIncorrect
Question 7 of 75
7. QuestionCategory: Physiological Integrity
A client has had a unilateral adrenalectomy to remove a tumor. To prevent complications, the most important measurement in the immediate postoperative period for the nurse to take is:CorrectIncorrect
Question 8 of 75
8. QuestionCategory: Physiological Integrity
A client with Addison’s disease has been admitted with a history of nausea and vomiting for the past 3 days. The client is receiving IV glucocorticoids (Solu-Medrol). Which of the following interventions would the nurse implement?CorrectIncorrect
Question 9 of 75
9. QuestionCategory: Physiological Integrity
A client had a total thyroidectomy yesterday. The client is complaining of tingling around the mouth and in the fingers and toes. What would the nurse’s next action be?CorrectIncorrect
Question 10 of 75
10. QuestionCategory: Physiological Integrity
A 32-year-old mother of three is brought to the clinic. Her pulse is 52, there is a weight gain of 30 pounds in 4 months, and the client is wearing two sweaters. The client is diagnosed with hypothyroidism. Which of the following nursing diagnoses is of highest priority?CorrectIncorrect
Question 11 of 75
11. QuestionCategory: Physiological Integrity
The client is having an arteriogram. During the procedure, the client tells the nurse, “I’m feeling really hot.” Which response would be best?CorrectIncorrect
Question 12 of 75
12. QuestionCategory: Physiological Integrity
The nurse is observing several healthcare workers providing care. Which action by the healthcare worker indicates a need for further teaching?CorrectIncorrect
Question 13 of 75
13. QuestionCategory: Physiological Integrity
The client is having electroconvulsive therapy for treatment of severe depression. Which of the following indicates that the client’s ECT has been effective?CorrectIncorrect
Question 14 of 75
14. QuestionCategory: Physiological Integrity
The 5-year-old is being tested for enterobiasis (pinworms). To collect a specimen for assessment of pinworms, the nurse should teach the mother to:CorrectIncorrect
Question 15 of 75
15. QuestionCategory: Physiological Integrity
The nurse is teaching the mother regarding treatment for enterobiasis. Which instruction should be given regarding the medication?CorrectIncorrect
Question 16 of 75
16. QuestionCategory: Safe and Effective Care Environment
The registered nurse is making assignments for the day. Which client should be assigned to the pregnant nurse?CorrectIncorrect
Question 17 of 75
17. QuestionCategory: Safe and Effective Care Environment
The nurse is planning room assignments for the day. Which client should be assigned to a private room if only one is available?CorrectIncorrect
Question 18 of 75
18. QuestionCategory: Safe and Effective Care Environment
The nurse caring for a client in the neonatal intensive care unit administers adult-strength Digitalis to the 3-pound infant. As a result of her actions, the baby suffers permanent heart and brain damage. The nurse can be charged with:CorrectIncorrect
Question 19 of 75
19. QuestionCategory: Safe and Effective Care Environment
Which assignment should not be performed by the licensed practical nurse?CorrectIncorrect
Question 20 of 75
20. QuestionCategory: Physiological Integrity
The client returns to the unit from surgery with a blood pressure of 90/50, pulse 132, and respirations 30. Which action by the nurse should receive priority?CorrectIncorrect
Question 21 of 75
21. QuestionCategory: Safe and Effective Care Environment
Which nurse should be assigned to care for the postpartum client with preeclampsia?CorrectIncorrect
Question 22 of 75
22. QuestionCategory: Safe and Effective Care Environment
Which information should be reported to the state Board of Nursing?CorrectIncorrect
Question 23 of 75
23. QuestionCategory: Safe and Effective Care Environment
The nurse is suspected of charting medication administration that he did not give. After talking to the nurse, the charge nurse should:CorrectIncorrect
Question 24 of 75
24. QuestionCategory: Safe and Effective Care Environment
The home health nurse is planning for the day’s visits. Which client should be seen first?CorrectIncorrect
Question 25 of 75
25. QuestionCategory: Safe and Effective Care Environment
The emergency room is flooded with clients injured in a tornado. Which clients can be assigned to share a room in the emergency department during the disaster?CorrectIncorrect
Question 26 of 75
26. QuestionCategory: Physiological Integrity
The nurse is caring for a 6-year-old client admitted with a diagnosis of conjunctivitis. Before administering eye drops, the nurse should recognize that it is essential to consider which of the following?CorrectIncorrect
Question 27 of 75
27. QuestionCategory: Health Promotion and Maintenance
The nurse is discussing meal planning with the mother of a 2-year-old toddler. Which of the following statements, if made by the mother, would require a need for further instruction?CorrectIncorrect
Question 28 of 75
28. QuestionCategory: Physiological Integrity
A 2-year-old toddler is admitted to the hospital. Which of the following nursing interventions would you expect?CorrectIncorrect
Question 29 of 75
29. QuestionCategory: Health Promotion and Maintenance
Which instruction should be given to the client who is fitted for a behind-the-ear hearing aid?CorrectIncorrect
Question 30 of 75
30. QuestionCategory: Physiological Integrity
A priority nursing diagnosis for a child being admitted from surgery following a tonsillectomy is:CorrectIncorrect
Question 31 of 75
31. QuestionCategory: Physiological Integrity
A client with bacterial pneumonia is admitted to the pediatric unit. What would the nurse expect the admitting assessment to reveal?CorrectIncorrect
Question 32 of 75
32. QuestionCategory: Safe and Effective Care Environment
The nurse is caring for a client admitted with epiglottitis. Because of the possibility of complete obstruction of the airway, which of the following should the nurse have available?CorrectIncorrect
Question 33 of 75
33. QuestionCategory: Physiological Integrity
A 25-year-old client with Grave’s disease is admitted to the unit. What would the nurse expect the admitting assessment to reveal?CorrectIncorrect
Question 34 of 75
34. QuestionCategory: Health Promotion and Maintenance
The nurse is providing dietary instructions to the mother of an 8-year-old child diagnosed with celiac disease. Which of the following foods, if selected by the mother, would indicate her understanding of the dietary instructions?CorrectIncorrect
Question 35 of 75
35. QuestionCategory: Physiological Integrity
The nurse is caring for an 80-year-old with chronic bronchitis. Upon the morning rounds, the nurse finds an O2 sat of 76%. Which of the following actions should the nurse take first?CorrectIncorrect
Question 36 of 75
36. QuestionCategory: Physiological Integrity
A gravida 3 para 0 is admitted to the labor and delivery unit. The doctor performs an amniotomy. Which observation would the nurse be expected to make after the amniotomy?CorrectIncorrect
Question 37 of 75
37. QuestionCategory: Physiological Integrity
The client is admitted to the unit. A vaginal exam reveals that she is 2cm dilated. Which of the following statements would the nurse expect her to make?CorrectIncorrect
Question 38 of 75
38. QuestionCategory: Physiological Integrity
The client is having fetal heart rates of 90–110 bpm during the contractions. The first action the nurse should take is:CorrectIncorrect
Question 39 of 75
39. QuestionCategory: Physiological Integrity
In evaluating the effectiveness of IV Pitocin for a client with secondary dystocia, the nurse should expect:CorrectIncorrect
Question 40 of 75
40. QuestionCategory: Physiological Integrity
A vaginal exam reveals a footling breech presentation. The nurse should take which of the following actions at this time?CorrectIncorrect
Question 41 of 75
41. QuestionCategory: Physiological Integrity
A vaginal exam reveals that the cervix is 4cm dilated, with intact membranes and a fetal heart tone rate of 160–170 bpm. The nurse decides to apply an external fetal monitor. The rationale for this implementation is:CorrectIncorrect
Question 42 of 75
42. QuestionCategory: Physiological Integrity
The following are all nursing diagnoses appropriate for a gravida 1 para 0 in labor. Which one would be most appropriate for the primigravida as she completes the early phase of labor?CorrectIncorrect
Question 43 of 75
43. QuestionCategory: Physiological Integrity
As the client reaches 8 cm dilation, the nurse notes late decelerations on the fetal monitor. The FHR baseline is 165–175 bpm with variability of 0–2bpm. What is the most likely explanation of this pattern?CorrectIncorrect
Question 44 of 75
44. QuestionCategory: Physiological Integrity
The nurse notes variable decelerations on the fetal monitor strip. The most appropriate initial action would be to:CorrectIncorrect
Question 45 of 75
45. QuestionCategory: Physiological Integrity
Which of the following is a characteristic of a reassuring fetal heart rate pattern?CorrectIncorrect
Question 46 of 75
46. QuestionCategory: Physiological Integrity
The rationale for inserting a French catheter every hour for the client with epidural anesthesia is:CorrectIncorrect
Question 47 of 75
47. QuestionCategory: Health Promotion and Maintenance
A client in the family planning clinic asks the nurse about the most likely time for her to conceive. The nurse explains that conception is most likely to occur when:CorrectIncorrect
Question 48 of 75
48. QuestionCategory: Health Promotion and Maintenance
A client tells the nurse that she plans to use the rhythm method of birth control. The nurse is aware that the success of the rhythm method depends on the:CorrectIncorrect
Question 49 of 75
49. QuestionCategory: Health Promotion and Maintenance
A client with diabetes asks the nurse for advice regarding methods of birth control. Which method of birth control is most suitable for the client with diabetes?CorrectIncorrect
Question 50 of 75
50. QuestionCategory: Physiological Integrity
The doctor suspects that the client has an ectopic pregnancy. Which symptom is consistent with a diagnosis of ectopic pregnancy?CorrectIncorrect
Question 51 of 75
51. QuestionCategory: Health Promotion and Maintenance
The nurse is teaching a pregnant client about nutritional needs during pregnancy. Which menu selection will best meet the nutritional needs of the pregnant client?CorrectIncorrect
Question 52 of 75
52. QuestionCategory: Physiological Integrity
The client with hyperemesis gravidarum is at risk for developing:CorrectIncorrect
Question 53 of 75
53. QuestionCategory: Health Promotion and Maintenance
A client tells the doctor that she is about 20 weeks pregnant. The most definitive sign of pregnancy is:CorrectIncorrect
Question 54 of 75
54. QuestionCategory: Physiological Integrity
The nurse is caring for a neonate whose mother is diabetic. The nurse will expect the neonate to be:CorrectIncorrect
Question 55 of 75
55. QuestionCategory: Health Promotion and Maintenance
Which of the following instructions should be included in the nurse’s teaching regarding oral contraceptives?CorrectIncorrect
Question 56 of 75
56. QuestionCategory: Health Promotion and Maintenance
The nurse is discussing breastfeeding with a postpartum client. Breastfeeding is contraindicated in the postpartum client with:CorrectIncorrect
Question 57 of 75
57. QuestionCategory: Physiological Integrity
A client is admitted to the labor and delivery unit complaining of vaginal bleeding with very little discomfort. The nurse’s first action should be to:CorrectIncorrect
Question 58 of 75
58. QuestionCategory: Physiological Integrity
A client telephones the emergency room stating that she thinks that she is in labor. The nurse should tell the client that labor has probably begun when:CorrectIncorrect
Question 59 of 75
59. QuestionCategory: Health Promotion and Maintenance
The nurse is teaching a group of prenatal clients about the effects of cigarette smoke on fetal development. Which characteristic is associated with babies born to mothers who smoked during pregnancy?CorrectIncorrect
Question 60 of 75
60. QuestionCategory: Physiological Integrity
The physician has ordered an injection of RhoGam for the postpartum client whose blood type is A negative but whose baby is O positive. To provide postpartum prophylaxis, RhoGam should be administered:CorrectIncorrect
Question 61 of 75
61. QuestionCategory: Physiological Integrity
After the physician performs an amniotomy, the nurse’s first action should be to assess the:CorrectIncorrect
Question 62 of 75
62. QuestionCategory: Physiological Integrity
A client is admitted to the labor and delivery unit. The nurse performs a vaginal exam and determines that the client’s cervix is 5 cm dilated with 75% effacement. Based on the nurse’s assessment the client is in which phase of labor?CorrectIncorrect
Question 63 of 75
63. QuestionCategory: Health Promotion and Maintenance
A newborn with narcotic abstinence syndrome is admitted to the nursery. Nursing care of the newborn should include:CorrectIncorrect
Question 64 of 75
64. QuestionCategory: Health Promotion and Maintenance
A client elects to have epidural anesthesia to relieve the discomfort of labor. Following the initiation of epidural anesthesia, the nurse should give priority to:CorrectIncorrect
Question 65 of 75
65. QuestionCategory: Safety and Infection Control
The nurse is aware that the best way to prevent postoperative wound infection in the surgical client is to:CorrectIncorrect
Question 66 of 75
66. QuestionCategory: Physiological Integrity
The elderly client is admitted to the emergency room. Which symptom is the client with a fractured hip most likely to exhibit?CorrectIncorrect
Question 67 of 75
67. QuestionCategory: Health Promotion and Maintenance
The nurse knows that a 60-year-old female client’s susceptibility to osteoporosis is most likely related to:CorrectIncorrect
Question 68 of 75
68. QuestionCategory: Physiological Integrity
A 2-year-old is admitted for repair of a fractured femur and is placed in Bryant’s traction. Which finding by the nurse indicates that the traction is working properly?CorrectIncorrect
Question 69 of 75
69. QuestionCategory: Physiological Integrity
A client with a fractured hip has been placed in Buck’s traction. Which statement is true regarding balanced skeletal traction? Balanced skeletal traction:CorrectIncorrect
Question 70 of 75
70. QuestionCategory: Safe and Effective Care Environment
The client is admitted for an open reduction internal fixation of a fractured hip. Immediately following surgery, the nurse should give priority to assessing the:CorrectIncorrect
Question 71 of 75
71. QuestionCategory: Health Promotion and Maintenance
Which statement made by the family member caring for the client with a percutaneous gastrostomy tube indicates an understanding of the nurse’s teaching?CorrectIncorrect
Question 72 of 75
72. QuestionCategory: Physiological Integrity
The nurse is assessing the client with a total knee replacement 2 hours postoperative. Which information requires notification of the doctor?CorrectIncorrect
Question 73 of 75
73. QuestionCategory: Health Promotion and Maintenance
The nurse is caring for the client with a 5-year-old diagnosis of plumbism. Which information in the health history is most likely related to the development of plumbism?CorrectIncorrect
Question 74 of 75
74. QuestionCategory: Safe and Effective Care Environment
A client with a total hip replacement requires special equipment. Which equipment would assist the client with a total hip replacement with activities of daily living?CorrectIncorrect
Question 75 of 75
75. QuestionCategory: Physiological Integrity
An elderly client with an abdominal surgery is admitted to the unit following surgery. In anticipation of complications of anesthesia and narcotic administration, the nurse should: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.