Preparing for NCLEX-RN

Purpose of NCLEX-RN
The purpose of this examination is to protect the safety of the public. The examination is designed to determine whether candidates for licensure as registered nurses have the minimum level of knowledge needed to practice competently, knowledgeably, and safely at an entry level.

In preparing for the examination, key words from the stated purpose of the examination that you should think about are minimum level, safely, and entry level. These words can help focus your preparation and ease your mind. What they tell you is that the examination questions will test general principles and commonly encountered patient care situations. The focus will not be on testing obscure pieces of knowledge applicable only rarely in practice. Neither will the test focus on situations that demand a complexity of judgment, which can be expected only with time and experience. What can be expected to be stressed are nursing assessments and actions that protect patients from harm. This means that in preparing, you must give special attention to facts and procedures that promote physical safety, emotional safety, and protection from, or early identification of, disease complications or iatrogenic problems.

Development of the NCLEX-RN
Knowing the basic process by which the examination is developed will further help direct your preparation. It will reinforce the fact that the questions focus on critical information regularly used by new graduates in daily

NCLEX-RN has been developed by the National
Council of State Boards of Nursing (NCSBN) and is updated on the basis of a work-study analysis of what new graduates do in the workplace. All aspects of nursing practice are observed and then classified into categories and subcategories. These categories and subcategories then form the basis of the test plan, which specifies the content to be covered and the number of questions to be asked related to each area. Job analyses are done periodically and the test plan is that the test remains accurate and consistent with current
practice. Content of the examination is matched to the scope of practice. In selecting the content to be tested, there are two major considerations: the frequency with which the information is needed in day-to-day practice and the criticality of the information to the patient.

The test questions are written by nurses who practice in a setting where they work with new graduates. The questions are carefully edited for any type of bias. They are also reviewed for clarity and correctness of the key by other practitioners. This ensures that the questions and answers represent accepted principles of safe practice and not a regional practice or opinion.

The Test Plan Content
The content is organized around four categories of human needs, which have been identified by the NCSBN. The four categories and their related subcategories are as follows:
• Safe, effective care environment
—Management of care
—Safety and infection control
• Health promotion and maintenance
—Growth and development through the lifespan
—Prevention and early detection of disease
• Psychosocial integrity
—Coping and adaptation
—Psychosocial adaptation
• Physiological integrity
—Basic care and comfort
—Pharmacological and parenteral therapies
—Reduction of risk potential
—Physiological adaptation
Each of these subcategories constitutes 5–13% of the test except for Reduction of Risk Potential and Physiological Adaptation each of which accounts for 12–18% of the total questions. Integrated throughout each of the client needs categories are the steps of the nursing process, caring, communication and documentation, and teaching and learning.

In preparing for any examination, it is always helpful to have some idea of what to expect in terms of style. This helps prevent surprises, which can be distracting and can create anxiety. Knowing about the examination style in advance, helps free your mind to focus on the content of the questions. Some key points about the style of the NCLEXRN are that it
• uses the term “client,” not “patient,” to refer to the recipient of care.
• is an integrated examination, that is, it covers clients of all ages, backgrounds, and levels of health or illness.
• is gender neutral.
• is reviewed to remove any culturally biased terms.
• has primarily a multiple-choice format: stem and four options only one of which is the answer to the question.
• includes some other types of questions, for example, —those that require the test taker to fill in the blanks with numerals or words rather than selecting an answer from a list of four options.
What is the normal heart rate in a newborn?
_____beats per minute.
—those that contain pictures/diagrams and ask the test taker to identify a particular site by touching the correct area on the diagram.
Where would the nurse auscultate for the apical pulse? The test taker has to touch an area on a diagram of the
chest. If the test taker touches the correct area or “hot spot,” the answer is correct.
—those that present a list of assessment findings or nursing actions, etc., and ask the test taker to identify all those that are appropriate for a particular type of patient.
Which of the following are risk factors for cancer of the breast?
Mark all that apply.
■ Family history
■ Nulliparity
■ Age over 50 years
■ Late menopause
■ Breast-feeding
■ Cigarette smoking
■ Provides a drop-down calculator as needed.
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