Failed NCLEX-RN - need help indentifying weaknesses

Nursing Students NCLEX

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Specializes in NICU, Pediatrics, Nursing Education.

Hello all,

I took the NCLEX-RN for the first time on June 25th and found out on June 29th that I failed. Obviously, I was pretty devastated. I graduated with University Honors and Sigma Theta Tau honors from a pretty decent BSN school. I consider myself a fairly smart individual. I graduated with a cumulative GPA of exactly 3.5 and I only made 1 C during my entire nursing school career. Granted, I did make a lot of B's, but I feel like that's still pretty good. Also, I scored a 98% predicted probability of passing NCLEX the first time according to my ATI exam.

I realize that the NCLEX-RN is not an IQ or aptitude test... I had to tell myself this over and over for days after I found out that I failed... because I felt "stupid." So I took about 1.5 weeks off to just be lazy and try not to stress about the test.

I went to the library and checked out the Kaplan Test Strategy book and Lippincott's Incredibly Easy Workout. I feel like the former is more helpful than the latter. I also got the Saunders Strategy book via an interlibrary loan and I feel like it's super helpful. I am using the NCLEX 4000 CD, the 2 CD's with the Kaplan and Saunders book, and the CD that comes with the Evolve/HESI NCLEX-RN Review book (I got this book last year to help me pass HESI the second go-around).

I worked for a year as a tech in the NICU at a local hospital here and got a job as an RN... and now I can't start work and the whole thing puts my job in jeopardy somewhat. I think the only reason my boss is trying to work with me to get me on the unit after failing NCLEX is because the staff and nurses have spoken so highly of me and have told me that they really want me to work with them. I have a passion and devotion to nursing and worked as hard as I could during my year on my unit because I knew after about a month that it is where I wanted to start my RN career.

I am just not sure what my weaknesses are... or how to fix them. I ended up taking all 265 questions and I will admit that once I got to question 76, I was extremely irritable. I had spoken with classmates that described the test as being a breeze and people had passed that made lower scores than me during nursing school. Before the test, I did about 1,000 practice questions... about 600 were from the Hurst practice tests and the other 400 were from the NCLEX-4000 CD. I think that my problem for the test was 1) Assuming the test would be easy based on other people's experiences and 2) Relying so much on the Hurst (it wasn't a bad review, but I should have been more objective and diverse with my resources for practice questions).

I got back my summary report and here it is:

Management of Care (16-22% of the test) - NEAR THE PASSING STANDARD

Safety and Infection Control (8-14% of the test) - NEAR THE PASSING STANDARD

Health Promotion and Maintenance (6-12% of the test) - NEAR THE PASSING STANDARD

Psychosocial Integrity (6-12% of the test) - NEAR THE PASSING STANDARD

Basic Care and Comfort (6-12% of the test) - NEAR THE PASSING STANDARD

Pharmacological and Parenteral Therapies (13-19% of the test) - NEAR THE PASSING STANDARD

Reduction of Risk Potential (10-16% of the test) - ABOVE THE PASSING STANDARD

Physiological Adaptation (11-17% of the test) - NEAR THE PASSING STANDARD

So, 7/8 categories were near the passing standard and 1/8 was above. How close am I? Was this related to general test anxiety (I slept horrible the night before the test, but I didn't feel particularly nervous during the test)? Do I need to use a more content based review approach, a strategy review approach, or both? I am trying to do both... but I just really want to pass the 2nd time so I can move on with my life.

Any advice, suggestions, or help is greatly appreciated.

I would not waste any time trying to analyze the first test. Instead start over. Devise a study plan and approach your task at hand as if you had never tested before. You are going to pass when your knowledge of the material is demonstrated by your ability to answer a sufficient number of questions worded the way they word them. The better you know the material, the more likely you will be to be able to answer the questions correctly. It is no more complex than that.

Specializes in NICU, Pediatrics, Nursing Education.

I know that you are correct and that I shouldn't dwell so much on my first attempt. I am just nervous about taking it again and I really want to feel prepared.

So far I have done 1000 practice questions total from all of my resources and read 100-150 pages from the different strategy books on how to break down a question, reword a question, and look at the 4 answer choices for similarities, differences, and word clues. My goal is to try and do somewhere around 3000-4000 practice questions, however I won't beat myself up if I don't reach a certain number because I'd rather take my time and review each question in order to learn that just burn through a ton of questions just to say that I did x amount of questions.

I did the practice test in the Kaplan book and made a 65% - the book advised that according to this particular score that I need to probably do some mild review, as well as brush up on my test strategies. I've been doing the practice questions in the Saunders book by chapter and so far have made:

Fundamentals - 21/25 = 84%

Adult Health - 22/35 = 63%

Psych - 18/22 = 82%

Maternity - 19/24 = 79%

Peds - 29/35 = 83%

Pharm - 23/24 = 96%

Obviously, I need to work on Adult Health, which may be why I failed since a large portion of the test felt directed towards general med-surg/adult health issues. I don't feel like I am that great in pharm... the questions in Saunders don't necessarily match up to NCLEX when it comes to pharm. A lot of times they give the disease process and NCLEX never, ever does... so I need to find something that won't give me the disease.

I also realize that I don't need to get so hung up on numbers. I have saved the 2nd 180 question practice test on the Kaplan CD and will see if I do any better on it after using the Saunders book. I need to review my infection control on communicable diseases, normal lab values, and I guess anything else I can.

I try to do about 100 practice questions everyday and some light reading. I have been keeping a Study Log where I write down the date, how many questions I took and over what material, and my score. I feel like it kind of helps my self esteem to be able to open up my notebook and see what all I have accomplished so far. I also have about 13 pages of notes over material I didn't know or forget when reviewing my rationales.

I know that preparation is the key to feeling confident and the two combined together will really give me a good shot at passing. I'm so tired of this hanging over my head and haunting me daily.

Specializes in Medical and general practice now LTC.

You really need to start over as if you haven't tested before. If you have the Saunders book do the questions at the end of each chapter and see how you do. Then just concentrate on answering questions and reading the rationales (use which ever book suits you) and only read up on a subject if you are struggling answering questions. i.e you do a 100 questions on obstetrics and you score poorly then study obstetrics and redo the questions and hopefully you will do better

I found LaCharity's book on Prioritization, Delegation very helpful. The case studies really make you think. Don't forget to read all of the rationale even on the ones you get right. It helped me think of things that I had forgotten. Sometimes I got questions right but not for the right reason. I watched some YouTube videos on subjects I didn't understand for example from ed4nurses. I am a visual learner so I liked to use many resources even Google images like I looked up Steven-Johnson syndrome and it helped me visualize it (very nasty allergic type side effect from Dilantin and others). We are living in a great age for information. I learned a lot from this site as well - lots of great links and infection control etc. Hope this helps.

Specializes in NICU, Pediatrics, Nursing Education.

Just thought I'd give an update. I've currently done 3,517 practice questions with a total average of 71%. Since NCLEX is graded so crazy, the average part really doesn't mean much... other than to boost my self confidence.

I've done all types of questions (have tried focusing a lot on analysis questions because those are harder for me). I've been using Kaplan, Mosby, Saunders, Lippincott, and a book endorsed by NSNA.

I took a 180 Kaplan practice test today and made 69%... 1 question away from 70% (which 70% or better is optimal according to their book).

I got my ATT on Friday and am scheduled for boards Tuesday Aug. 31st at 2 pm. Last time I took the test at 8 AM and I'm not a morning person, so I'm hoping this will help, as well. I can't eat breakfast early in the morning because I get nauseous, this way I will be able to have lunch before the test.

A nurse suggested to me yesterday to take an Ativan before the test... :confused: I was very shocked and appalled that anyone (especially a licensed health care provider) would suggest such a thing. I feel like that would almost be cheating (or I guess doing yourself a disservice if you were so zonked out that you couldn't think straight).

So the gist of it is there will be no Ativan, Xanax, or anything else for me before NCLEX (except a huge bowl of macaroni and cheese :D). Even if I have to take it 10 times, I will pass it the old fashioned way.

I couldn't sleep tonight so I figure I browse the boards but anyways.....

The first time I took the test I too had 265 questions. My scores were just as identical as yours except for 1 category. 1st exam strategy: Did ALL Kaplan questions in 12 days with minimal reading.

I took it a second time at the beginning of this month and failed at 84 questions. I did more reading on the material than practicing questions.I literally was putting in 12 hour days on my studying. Everyone thought I was insane and some were telling me to kick back on the reading and spend more time on questions.

I take mine for the 3rd time in a few weeks. And of course I'm nervous as hell. I too have made a log of how many questions I have completed along with the scores and did some reading at a minimal. And in addition, I started studying by myself. I studied with a girl who failed just like me but felt like I was being counter productive because she always wants to borrow my books and other related material.

I just need to find more practice questions. As far as the reading goes, I'm sticking to the Hurst Review book that was given in class. I felt that it helped me a lot on diseases and some basics

And I totally agree with you that this test doesn't detect your IQ. Believe me, I have graduated with people who barely scraped by in class and passed with flying colors and in fact don't deserve to be a nurse for undisclosed reasons.

Good luck on your upcoming exam!

Specializes in NICU, Pediatrics, Nursing Education.

SDtoKY

Maybe you studied too hard for your 2nd attempt? I know that sounds crazy and the test is so hard, saying that someone studied too hard sounds insane. But maybe you burned yourself out on all the content.

As for questions, I've gotten quite a few resources from my local library. They only had the Kaplan Strategy book in their catalog, so I ordered 5 books via their inter-library loan. I went on Google and looked at what the majority of people found helpful to study... and ordered those books.

I have Kaplan Strategy, Kaplan Meds to Know, Mosby, NSNA endorsed book, and two Saunders books. I also used some questions from a Lippincott book that I had borrowed last year from a former nursing student to study for HESI... it was an older version, 2007 I believe. I only did a few questions from it as I was not sure that it would be updated enough for information and NCLEX style questions.

I've also been using the NCLEX 4000 CD. My friend did 100 + questions from this CD everyday for a month and passed NCLEX with 75 questions. However, you never know if someone would have passed NCLEX anyways, or if the material they used really helped. Results, study habits, and experiences are very individualized depending upon the person... so just because something worked for someone else doesn't mean it'll work for you.

I have been trying to get questions from each book somewhat equally in an effort to stay diverse with the way NCLEX may ask me questions. The one thing I like about the Mosby and Saunders CD's is that you can pick if you want knowledge, comprehension, application, or analysis questions. I figured that since my results were all near passing that I probably needed to work on application and analysis the most.

I hope this helps... I would really encourage you to use your library. Good luck to you! Hang in there and don't give up.

maybe your over analyzing.

irish_rainbow

I admit, I did burn myself.

I was exhausted after the test. But I should have practiced more questions and studied by myself. And did I fail to mention, I didn't take any breaks. And if I did, I'd took a break for like 5 mins and start again.

I've been doing questions from this site and also from Hurst Review. I'll look over other sources once these run dry.

University of Texas Medical Branch - Nursing

I will keep fighting until I get this. I just won't overstudy and blow a gasket in the process

I'll just practice questions, do some light reading and be patient. Good luck!

Specializes in NICU, Pediatrics, Nursing Education.

I know what you mean, SDtoKY. During my first attempt, the only breaks I took were the two scheduled ones given by the computer. I was very stubborn and kept thinking "This thing has to end soon. I know I'm smart... and a lot smarter than some of my classmates that passed this test."

This type of thinking will kill you when it comes to NCLEX. I realize now that instead of fighting NCLEX, you must use it to your advantage by looking at the questions and what you are being asked... rather than thinking NCLEX is this evil test that you hate.

Regardless of why you didn't take more breaks, at least now you know that it was probably not the best choice. For my second attempt on Tuesday, I think I am going to take a break after the first 50 questions... I had originally decided to get through 75, but a friend who already passed it encouraged me to go to 50. I think after that I will take a break every hour or so... maybe more often than that if I feel tired.

I felt like I was going to annoy the testing people if I took too many breaks, but now I realize that 1) it's their job and 2) forget them... I'm trying to pass this test!

As far as questions and rationales go, I do believe that they are extremely helpful. For instance, I was doing questions yesterday and got this question about a sick diabetic. The question described how he was taking his blood sugar and giving himself his insulin... which all sounded good. The question wanted you to pick the nursing diagnoses that was most appropriate for the patient and I picked advanced health promotion or something to that affect because I was thinking he was doing everything correctly. When I read my rationale later, I saw that the answer was Deficient knowledge and the question said he was giving himself his insulin after meals. Doh! I just didn't read this question slow or long enough... so I am trying to work on that. Doing practice questions can really help you learn your weaknesses.

Thanks for the luck and encouragement... same to you. Good luck! You will conquer this!

Oh! P.S. The website that you posted... I believe that I made an account with them and the questions are from NCLEX 4000, so if you are using that then there is probably no need to go out and buy the NCLEX 4000 CD.

irish_rainbow

A buddy of mine told me the exam same thing. So I might have to adopt that. Besides we have 6 hours. But seriously who cares if you annoy the heck out of the people at the test center. Our main objective is to pass that exam.

I can give a flying *** what they think. They're not the ones having to spend 200 bucks to retake a test.

Anyways.. I haven't practiced any questions for the past couple of days. Work and spending time at the pool and all that fun. I will continue on monday. However I did read a little bit of material at the pool. I retained every bit of it. Why? Because I'm relaxed like I should be and not all stressed out. Im trying to balance out from being too relaxed to being all high strung and trying to memorize everything. Just trying to stay relaxed and calm.

I wanna say once more, good luck to you on your upcoming second attempt. Your study schedule seems your like on the right path to beating this thing. And of course we all will!

As for the questions go, I didn't realize that was the nclex4000 people have been talking about. Thanks for the info. And yeah I do recognize that diabetes question.

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