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 #9: 75 Questions
Welcome to the 9th set of practice questions for the NCLEX-RN. Another 75 NCLEX practice questions.
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- Physiological Adaptation 0%
- Psychosocial Integrity 0%
- Reduction of Risk Potential 0%
- Safety and Infection Control 0%
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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: Basic Care and Comfort
Which roommate would be most suitable for the 6-year-old male with a fractured femur in Russell’s traction?CorrectIncorrect
Question 2 of 75
2. QuestionCategory: Health Promotion and Maintenance
A client with osteoarthritis has a prescription for celebrex (Celecoxib). Which instruction should be included in the discharge teaching?CorrectIncorrect
Question 3 of 75
3. QuestionCategory: Safety and Infection Control
A client with a fractured tibia has a plaster-of-Paris cast applied to immobilize the fracture. Which action by the nurse indicates an understanding of a plaster-of-Paris cast? The nurse:CorrectIncorrect
Question 4 of 75
4. QuestionCategory: Basic Care and Comfort
The teenager with a fiberglass cast asks the nurse if it will be okay to allow his friends to autograph his cast. Which response would be best?CorrectIncorrect
Question 5 of 75
5. QuestionCategory: Management of Care
The nurse is assigned to care for the client with a Steinmann pin. During pin care, she notes that the LPN uses sterile gloves and Q-tips to clean the pin. Which action should the nurse take at this time?CorrectIncorrect
Question 6 of 75
6. QuestionCategory: Reduction of Risk Potential
A child with scoliosis has a spica cast applied. Which action specific to the spica cast should be taken?CorrectIncorrect
Question 7 of 75
7. QuestionCategory: Safety and Infection Control
The client with a cervical fracture is placed in traction. Which type of traction will be utilized at the time of discharge?CorrectIncorrect
Question 8 of 75
8. QuestionCategory: Physiological Adaptation
A client with a total knee replacement has a CPM (continuous passive motion device) applied during the postoperative period. Which statement made by the nurse indicates an understanding of the CPM machine?CorrectIncorrect
Question 9 of 75
9. QuestionCategory: Safety and Infection Control
A client with a fractured hip is being taught correct use of the walker. The nurse is aware that the correct use of the walker is achieved if the:CorrectIncorrect
Question 10 of 75
10. QuestionCategory: Physiological Adaptation
When assessing a laboring client, the nurse finds a prolapsed cord. The nurse should:CorrectIncorrect
Question 11 of 75
11. QuestionCategory: Pharmacological and Parenteral Therapies
The client presents to the clinic with a serum cholesterol of 275 mg/dL and is placed on rosuvastatin (Crestor). Which instruction should be given to the client?CorrectIncorrect
Question 12 of 75
12. QuestionCategory: Pharmacological and Parenteral Therapies
The client is admitted to the hospital with hypertensive crises. Diazoxide (Hyperstat) is ordered. During administration, the nurse should:CorrectIncorrect
Question 13 of 75
13. QuestionCategory: Pharmacological and Parenteral Therapies
The 6-month-old client with a ventral septal defect is receiving Digitalis for regulation of his heart rate. Which finding should be reported to the doctor?CorrectIncorrect
Question 14 of 75
14. QuestionCategory: Pharmacological and Parenteral Therapies
The client admitted with angina is given a prescription for nitroglycerin. The client should be instructed to:CorrectIncorrect
Question 15 of 75
15. QuestionCategory: Basic Care and Comfort
The client is instructed regarding foods that are low in fat and cholesterol. Which diet selection is lowest in saturated fats?CorrectIncorrect
Question 16 of 75
16. QuestionCategory: Reduction of Risk Potential
The client is admitted with right-sided congestive heart failure. In assessing the client for edema, the nurse should check the:CorrectIncorrect
Question 17 of 75
17. QuestionCategory: Reduction of Risk Potential
The nurse is checking the client’s central venous pressure. The nurse should place the zero of the manometer at the:CorrectIncorrect
Question 18 of 75
18. QuestionCategory: Pharmacological and Parenteral Therapies
The physician orders lisinopril (Zestril) and furosemide (Lasix) to be administered concomitantly to the client with hypertension. The nurse should:CorrectIncorrect
Question 19 of 75
19. QuestionCategory: Physiological Adaptation
The best method of evaluating the amount of peripheral edema is:CorrectIncorrect
Question 20 of 75
20. QuestionCategory: Reduction of Risk Potential
A client with vaginal cancer is being treated with a radioactive vaginal implant. The client’s husband asks the nurse if he can spend the night with his wife. The nurse should explain that:CorrectIncorrect
Question 21 of 75
21. QuestionCategory: Basic Care and Comfort
The nurse is caring for a client hospitalized with a facial stroke. Which diet selection would be suited to the client?CorrectIncorrect
Question 22 of 75
22. QuestionCategory: Pharmacological and Parenteral Therapies
The physician has prescribed Novolog insulin for a client with diabetes mellitus. Which statement indicates that the client knows when the peak action of the insulin occurs?CorrectIncorrect
Question 23 of 75
23. QuestionCategory: Health Promotion and Maintenance
The nurse is teaching basic infant care to a group of first-time parents. The nurse should explain that a sponge bath is recommended for the first 2 weeks of life because:CorrectIncorrect
Question 24 of 75
24. QuestionCategory: Pharmacological and Parenteral Therapies
A client with leukemia is receiving Trimetrexate. After reviewing the client’s chart, the physician orders Wellcovorin (leucovorin calcium). The rationale for administering leucovorin calcium to a client receiving Trimetrexate is to:CorrectIncorrect
Question 25 of 75
25. QuestionCategory: Health Promotion and Maintenance
A 4-month-old is brought to the well-baby clinic for immunization. In addition to the DPT and polio vaccines, the baby should receive:CorrectIncorrect
Question 26 of 75
26. QuestionCategory: Pharmacological and Parenteral Therapies
The physician has prescribed esomeprazole (Nexium) for a client with erosive gastritis. The nurse should administer the medication:CorrectIncorrect
Question 27 of 75
27. QuestionCategory: Psychosocial Integrity
A client on the psychiatric unit is in an uncontrolled rage and is threatening other clients and staff. What is the most appropriate action for the nurse to take?CorrectIncorrect
Question 28 of 75
28. QuestionCategory: Health Promotion and Maintenance
When the nurse checks the fundus of a client on the first postpartum day, she notes that the fundus is firm, is at the level of the umbilicus, and is displaced to the right. The next action the nurse should take is to:CorrectIncorrect
Question 29 of 75
29. QuestionCategory: Physiological Adaptation
A client is admitted to the hospital with a temperature of 99.8°F, complaints of blood-tinged hemoptysis, fatigue, and night sweats. The client’s symptoms are consistent with a diagnosis of:CorrectIncorrect
Question 30 of 75
30. QuestionCategory: Pharmacological and Parenteral Therapies
The client is seen in the clinic for treatment of migraine headaches. The drug Imitrex (sumatriptan succinate) is prescribed for the client. Which of the following in the client’s history should be reported to the doctor?CorrectIncorrect
Question 31 of 75
31. QuestionCategory: Physiological Adaptation
The client with suspected meningitis is admitted to the unit. The doctor is performing an assessment to determine meningeal irritation and spinal nerve root inflammation. A positive Kernig’s sign is charted if the nurse notes:CorrectIncorrect
Question 32 of 75
32. QuestionCategory: Psychosocial Integrity
The client with Alzheimer’s disease is being assisted with activities of daily living when the nurse notes that the client uses her toothbrush to brush her hair. The nurse is aware that the client is exhibiting:CorrectIncorrect
Question 33 of 75
33. QuestionCategory: Psychosocial Integrity
The client with dementia is experiencing confusion late in the afternoon and before bedtime. The nurse is aware that the client is experiencing what is known as:CorrectIncorrect
Question 34 of 75
34. QuestionCategory: Psychosocial Integrity
The client with confusion says to the nurse, “I haven’t had anything to eat all day long. When are they going to bring breakfast?” The nurse saw the client in the day room eating breakfast with other clients 30 minutes before this conversation. Which response would be best for the nurse to make?CorrectIncorrect
Question 35 of 75
35. QuestionCategory: Pharmacological and Parenteral Therapies
The doctor has prescribed Exelon (rivastigmine) for the client with Alzheimer’s disease. Which side effect is most often associated with this drug?CorrectIncorrect
Question 36 of 75
36. QuestionCategory: Reduction of Risk Potential
A client is admitted to the labor and delivery unit in active labor. During the examination, the nurse notes a papular lesion on the perineum. Which initial action is most appropriate?CorrectIncorrect
Question 37 of 75
37. QuestionCategory: Physiological Adaptation
A client with a diagnosis of HPV is at risk for which of the following?CorrectIncorrect
Question 38 of 75
38. QuestionCategory: Physiological Adaptation
During the initial interview, the client reports that she has a lesion on the perineum. Further investigation reveals a small blister on the vulva that is painful to touch. The nurse is aware that the most likely source of the lesion is:CorrectIncorrect
Question 39 of 75
39. QuestionCategory: Physiological Adaptation
A client visiting a family planning clinic is suspected of having an STI. The best diagnostic test for treponema pallidum is:CorrectIncorrect
Question 40 of 75
40. QuestionCategory: Reduction of Risk Potential
A 15-year-old primigravida is admitted with a tentative diagnosis of HELLP syndrome. Which laboratory finding is associated with HELLP syndrome?CorrectIncorrect
Question 41 of 75
41. QuestionCategory: Reduction of Risk Potential
The nurse is assessing the deep tendon reflexes of a client with preeclampsia. Which method is used to elicit the biceps reflex?CorrectIncorrect
Question 42 of 75
42. QuestionCategory: Safety and Infection Control
A primigravida with diabetes is admitted to the labor and delivery unit at 34 weeks gestation. Which doctor’s order should the nurse question?CorrectIncorrect
Question 43 of 75
43. QuestionCategory: Reduction of Risk Potential
A diabetic multigravida is scheduled for an amniocentesis at 32 weeks gestation to determine the L/S ratio and phosphatidylglycerol level. The L/S ratio is 1:1 and the presence of phosphatidylglycerol is noted. The nurse’s assessment of this data is:CorrectIncorrect
Question 44 of 75
44. QuestionCategory: Health Promotion and Maintenance
Which observation in the newborn of a diabetic mother would require immediate nursing intervention?CorrectIncorrect
Question 45 of 75
45. QuestionCategory: Pharmacological and Parenteral Therapies
The nurse caring for a client receiving intravenous magnesium sulfate must closely observe for side effects associated with drug therapy. An expected side effect of magnesium sulfate is:CorrectIncorrect
Question 46 of 75
46. QuestionCategory: Reduction of Risk Potential
The client has elected to have epidural anesthesia to relieve labor pain. If the client experiences hypotension, the nurse would:CorrectIncorrect
Question 47 of 75
47. QuestionCategory: Physiological Adaptation
A client has cancer of the pancreas. The nurse should be most concerned about which nursing diagnosis?CorrectIncorrect
Question 48 of 75
48. QuestionCategory: Reduction of Risk Potential
The nurse is caring for a client with ascites. Which is the best method to use for determining early ascites?CorrectIncorrect
Question 49 of 75
49. QuestionCategory: Physiological Adaptation
The client arrives in the emergency department after a motor vehicle accident. Nursing assessment findings include BP 80/34, pulse rate 120, and respirations 20. Which is the client’s most appropriate priority nursing diagnosis?CorrectIncorrect
Question 50 of 75
50. QuestionCategory: Safety and Infection Control
The home health nurse is visiting an 18-year-old with osteogenesis imperfecta. Which information obtained on the visit would cause the most concern? The client:CorrectIncorrect
Question 51 of 75
51. QuestionCategory: Reduction of Risk Potential
The nurse working the organ transplant unit is caring for a client with a decreased white blood cell count. During evening visitation, a visitor brings a basket of fruit. What action should the nurse take?CorrectIncorrect
Question 52 of 75
52. QuestionCategory: Physiological Adaptation
The nurse is caring for the client following a laryngectomy when suddenly the client becomes unresponsive and pale, with a BP of 90/40 systolic. The initial nurse’s action should be to:CorrectIncorrect
Question 53 of 75
53. QuestionCategory: Reduction of Risk Potential
The client admitted 2 days earlier that a lung resection accidentally pulls out the chest tube. Which action by the nurse indicates understanding of the management of chest tubes?CorrectIncorrect
Question 54 of 75
54. QuestionCategory: Reduction of Risk Potential
A client being treated with sodium warfarin has a Protime of 120 seconds. Which intervention would be most important to include in the nursing care plan?CorrectIncorrect
Question 55 of 75
55. QuestionCategory: Health Promotion and Maintenance
Which selection would provide the most calcium for the client who is 4 months pregnant?CorrectIncorrect
Question 56 of 75
56. QuestionCategory: Pharmacological and Parenteral Therapies
The client with preeclampsia is admitted to the unit with an order for magnesium sulfate. Which action by the nurse indicates understanding of the possible side effects of magnesium sulfate?CorrectIncorrect
Question 57 of 75
57. QuestionCategory: Management of Care
A 6-year-old client is admitted to the unit with a hemoglobin of 6g/dL. The physician has written an order to transfuse 2 units of whole blood. When discussing the treatment, the child’s mother tells the nurse that she does not believe in having blood transfusions and that she will not allow her child to have the treatment. What nursing action is most appropriate?CorrectIncorrect
Question 58 of 75
58. QuestionCategory: Physiological Adaptation
A client is admitted to the unit 2 hours after an explosion causes burns to the face. The nurse would be most concerned with the client developing which of the following?CorrectIncorrect
Question 59 of 75
59. QuestionCategory: Physiological Adaptation
The nurse is evaluating nutritional outcomes for a with anorexia nervosa. Which data best indicates that the plan of care is effective?CorrectIncorrect
Question 60 of 75
60. QuestionCategory: Physiological Adaptation
The client is admitted following repair of a fractured tibia and cast application. Which nursing assessment should be reported to the doctor?CorrectIncorrect
Question 61 of 75
61. QuestionCategory: Psychosocial Integrity
A client with a history of abusing barbiturates abruptly stops taking the medication. The nurse should give priority to assessing the client for:CorrectIncorrect
Question 62 of 75
62. QuestionCategory: Physiological Adaptation
During the assessment of a laboring client, the nurse notes that the FHT are loudest in the upper-right quadrant. The infant is most likely in which position?CorrectIncorrect
Question 63 of 75
63. QuestionCategory: Physiological Adaptation
The primary physiological alteration in the development of asthma is:CorrectIncorrect
Question 64 of 75
64. QuestionCategory: Basic Care and Comfort
A client with mania is unable to finish her dinner. To help her maintain sufficient nourishment, the nurse should:CorrectIncorrect
Question 65 of 75
65. QuestionCategory: Basic Care and Comfort
To maintain Bryant’s traction, the nurse must make certain that the child’s:CorrectIncorrect
Question 66 of 75
66. QuestionCategory: Reduction of Risk Potential
Which action by the nurse indicates understanding of herpes zoster?CorrectIncorrect
Question 67 of 75
67. QuestionCategory: Reduction of Risk Potential
The client has an order for a trough to be drawn on the client receiving Vancomycin. The nurse is aware that the nurse should contact the lab for them to collect the blood:CorrectIncorrect
Question 68 of 75
68. QuestionCategory: Health Promotion and Maintenance
The client using a diaphragm should be instructed to:CorrectIncorrect
Question 69 of 75
69. QuestionCategory: Health Promotion and Maintenance
The nurse is providing postpartum teaching for a mother planning to breastfeed her infant. Which of the client’s statements indicates the need for additional teaching?CorrectIncorrect
Question 70 of 75
70. QuestionCategory: Physiological Adaptation
Damage to the VII cranial nerve results in:CorrectIncorrect
Question 71 of 75
71. QuestionCategory: Pharmacological and Parenteral Therapies
A client is receiving Pyridium (phenazopyridine hydrochloride) for a urinary tract infection. The client should be taught that the medication may:CorrectIncorrect
Question 72 of 75
72. QuestionCategory: Reduction of Risk Potential
Which of the following tests should be performed before beginning a prescription of Accutane?CorrectIncorrect
Question 73 of 75
73. QuestionCategory: Pharmacological and Parenteral Therapies
A client with AIDS is taking Zovirax (acyclovir). Which nursing intervention is most critical during the administration of acyclovir?CorrectIncorrect
Question 74 of 75
74. QuestionCategory: Reduction of Risk Potential
A client is admitted for an MRI. The nurse should question the client regarding:CorrectIncorrect
Question 75 of 75
75. QuestionCategory: Pharmacological and Parenteral Therapies
The nurse is caring for the client receiving Amphotericin B. Which of the following indicates that the client has experienced toxicity to this drug?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.