How does the NCLEX Examination work?

Every nursing student has the same questions in regards to the NCLEX examination.
I thought it may be helpful to take a look at some of these questions to help you be
ready for what is coming.

Where do I start with the NCLEX?

Registering: obvious first step is signing up for your NCLEX exam, typically near
the end of your senior year of nursing school:
1.Apply to state board through website and pay fee
2.Authorization to Test (ATT) received about 30 days after state receives school
verification of degree
3.You schedule a date within 30 days of ATT or you risk expiration of your date

What about how the NCLEX is arranged and how it is graded? What does it
take to pass?
CAT: Computer Adaptive Test (i.e. they keep asking you questions from subjects you
get wrong, and leave ones you got right)
75-265 questions possible (15 dont count)
I personally know people that have passed and failed at 75, 135, and 265 so dont
despair
Max time allowed is 6 hours
Check Results in 48 hours on state website by doing a search for your name as a
REGISTERED NURSE!!!
Your NCLEX exam is graded in an adaptive form as well. Check out the following
picture while reading this description. You start off with easy questions and are at
the midline of the yellow block. If you get an easier question right, you get a point in
the positive direction (towards the green), while if you get an easy one wrong you
get 5 points in the negative direction (towards the red). If you get the easier one
right, you get a harder one that will give you 2 points in the positive direction, and if
wrong, 4 points in the negative direction. As you continue to get questions right,
you move to harder and harder ones, where eventually you will get 5 points in the
positive direction for a correct answer, and only 1 point in the negative direction for
a wrong one. For incorrect questions you also move to easier and easier questions,
which as stated, are worth less for correct and more for incorrect. At 75 questions
the computer does an analysis of your trend line and if you are in the green at this

point you are done and have passed your NCLEX exam, usually with greater than
58% correct. If you are in the red at this point you are done and have failed your
NCLEX, usually with less than 42% correct. If you are located in the yellow, your
NCLEX examination continues until the next random trend checkpoint.

What subjects are covered on the NCLEX?

Question Possibilities (Out of any 12 nclex questions)
Safe Effective Care:
Management: (2/12) Med Admin, Dx/Tx procedures
Safety/Infection Control: (1/12) Precautions (airborne, etc)
Health Promotion/Maintenance: (1/12) Development, Risk avoidance, recognize
alterations in health
Psychosocial Integrity: (1/12) Stress Coping, Problem solving
Physiologic Integrity
Basic Care/Comfort: (1/12) ADLS, Teaching (ie crutches)
Pharmacology: (2/12) Drug indications, routes, admin, S/E
Risk Reduction: (2/12) Prevent drug, tx, dz complications
Physiologic Adaptation: (2/12) Disease s/s, lab values
`
What types of questions styles are used on the NCLEX? I mean are they all
multiple choice?
Question Types
Multiple Choice
Fill in the blank
Multiple Response
Ordered Response
Figure/Illustrations
`

How do I study to pass the NCLEX examination?

In short...PREPARE EARLY! I would recommend starting to do NCLEX Review
questions at least by the start of your senior year. You can do this in conjunction
with your classes, where for example, you study NCLEX Review questions on
Pharmacology while studying for your Pharmacology class. Here is a schedule that I
recommend to my NCLEX Review students:
Success Plan
Fall: Use NCLEX review book with good summary section in all classes
While studying, combine class notes with book review (I built a study guide for all
tests out of both resources)
Do all questions pertaining to that section for each test
If you study in groups, have different books and quiz each other from these
Try to answer at least 100 NCLEX book questions before each test.
Total Questions Completed: 1000
Spring: During Role Synthesis, make a plan to cover all subjects/systems from a
new, mostly questions book
Plan 25/day
Mark % correct/incorrect for each section
Total Questions Completed: 2500
Summer: 60 days from grad to test
Focus on weakest sections first
Take at least 5 comprehensive tests (100 ?s)
Average 25/day for 1500 total
Total Questions Taken all year: 5000 +
I would be willing to say that your liklihood of passing the NCLEX is in direct relation
to how many practice questions you have done. If you can surpass the 5000
question goal, you have a very good chance of being ready for the NCLEX when it
comes your way.