Preface: I passed with 75 questions; I really believed I failed when I walked out - as does everyone else. I did the Pearson Vue Trick and got the "good pop-up." A few days later and way sooner than I expected, I see my name on the BON, and I'm jazzed. I told myself that if I passed the boards I would post up my "tips and tricks" about the NCLEX. There are tons of useful advice on this forum, but most of it is largely missing is insight. You can't recommend a book and not explain its pros and cons, you know? I hope to one day get into nursing education, so this will serve as practice for me.
First off, get yourself properly informed about the test. There are too many myths and unsubstantiated statements out there (e.g., "The test adapts to challenge you in your weak areas so if you get eight cancer questions in a row - it means you keep answering questions about cancer wrong," "You get randomly selected to do 265 questions," etc.). On the most basic level, if you miss a question, the computer gives you a simpler question; if you answer a question right, the computer gives you a harder question. Eventually, if you answer enough higher level questions, you pass the test. Simple (yeah right) as that. Second off, the worst thing you could possibly do to yourself is ask people, "What is on the test [in terms of content]?" This is like someone in Asia asking someone in California, "How's the weather in all of AMERICA?" The test is too vast, too enormous to even provide an iota of what is present. I've heard people say, "I had nothing but mental health questions" and "I had nothing but OB questions." It's just unrealistic to believe that. Plus, the test is predominantly application/analysis - not comprehension (read: rote memorization). In addition, question formats will vary from person to person: I was told to expect upwards of 20-30 SATA questions - I only got five. And just bringing it back to myths: SATA can be both below competency level questions AND passing level questions. I highly recommend that before you even touch a book you look (read: skim) through the NCSBN test plan (https://www.ncsbn.org/1287.htm). It will take literally five minutes to do, and you can get a good idea of what subject areas will be on the test. The test plan will also show you that the test isn't broken down in to subjects like "OB" and "Pediatrics," but rather, Health Promotion and Maintenance and Safe and Effective Care, etc.
Okay now that that's out of the way: I am a firm believer in the idea that the NCLEX requires a two prong attack of CONTENT and QUESTIONS. Content will give you a basis of information to pull from to answer the questions. As stated, the exam tests your critical thinking skills (probably more so than your nursing judgment, but that's my subjective belief). The "rote memorization" questions are considered lower level (read: below passing level) questions whereas the passing level questions are the ones you want to be getting AND hitting. Doing questions in important - especially a large quantity (>2000) and of high quality. Don't cheat yourself doing content questions - you'll always usually get these right. Do passing level questions that test your critical thinking skills - you'll struggle with these but they will train you to THINK, not MEMORIZE.
For content:
Saunders Comprehensive Review for the NCLEX-RN® Examination. This is a thick book. I did about 2-4 chapters a day, managing to knock out the 77 chapter behemoth in a little less than two months. I did this during my last semester of school so that as soon as I graduated, I could jump into questions. I didn't beat myself over the head trying to memorize everything; I treated it as a refresher of all I had learned and encountered in school. The book is incredibly well-written. The questions are too easy, however. They are geared more towards content than applicaton/analysis. And sometimes the answers just seem...off. Example being, a question about "autonomic dysreflexia" states that the first nursing intervention is to check the patency of a urinary catheter. Kaplan says to raise head of bed, which after extensive research on my own part, was the correct answer. (Not one for semantics, "right" means something different than "correct" in my own opinion. If anything, don't fish for the right answer - narrow your selection down to the MOST CORRECT answer.) While checking for catheter patency is part of the treatment algorithim, it wasn't the "true" answer. If anything, use the content questions to test you knowledge and assess gaps in knowledge. Do the SATA on the CD. They are legit and there is an abundance of them. You can even make a quiz that consists of nothing but SATA.
Kaplan NCLEX-RN Content Review Guide. I used this as a reference guide when I did Kaplan questions (which I'll mention in the next portion). When I finished Saunders and started doing Kaplan questions, I'd always refer back to this guide. Not because Kaplan questions will obviously pull from Kaplan-content, but because it felt more abridged than Saunders. If I needed more depth to my knowledge, I'd go to Saunders second.
For questions:
Kaplan Review Course. I liked this course...after I took the NCLEX. But no joke, prior to the boards, I was like, "Man, this class was a waste of my time. Decision Tree is whack - it makes no sense. Kaplan is a joke, etc." And for the most part, Decision Tree is joke. It only works for less than a third of the questions in my opinion. When a question asks about chronic renal failure and expected labs and the teacher busts out Decision Tree, you have to seriously just be like, "Come on...seriously?" And then sometimes, ABCs don't apply when there are ABCs "built in to" the question. The reason you take this course is to learn how the test is like and how the questions are formatted/worded. I totally understand that the review course lacks any type of content, but it's important for understanding the exam. If anything or you are strapped on cash, go pick up the Strategies, Practice, and Review book (http://www.amazon.com/NCLEX-RN-2012-2013-Strategies-Practice-Nclex-Rn/dp/1609785657) which is the review course contained in book format.
Kaplan Q Bank and Question Trainers (QTs). NCLEX is a test with questions, and that's why you should do questions: Doing questions trains you to do questions. NCLEX has a massive question bank that is ridiculously good. Start from your weak areas and move to your strong. You'll save more time that way, and if you become pressed for time before your exam, you at least targeted your problem areas. If you manage to complete all the question trainers (which are 7 practice tests, ranging from 75 questions to 265), don't go back and redo them because you'll start "fishing" for answers: You won't analyze the question then answer; you're just going look at the choices and pick what you remember. I recommend 150 questions a day, in 50 question blocks. I say, "Don't do them in tutor mode." Treat them as real tests because it will train you to sit there for a long time and do questions - which is what you will be doing during the NCLEX(!). And review the answers/rationales. Doing 150 questions is not the same as completing and reviewing 150 questions. And remember: All of Kaplan's questions are passing level questions - as in, these are the questions you want to be hitting. Go for accuracy, not speed. They are from the get-go pretty damn hard. I started at 50-60 percents per 50 questions and then managed 80-90 percents towards my final 200 Qbank questions. I scored >60% for QT1-3, >65 for QT4-5, >70 for QT6, and 66 on QT7. Whether or not the questions are "easier" or "harder" than the actual NCLEX is INSANELY SUBJECTIVE - but they are for sure worded in a similar fashion and even the interface is similar to the actual boards.
Prioritization, Delegation, and Assignment: Practice Exercises for the NCLEX Examination by La Charity. People on this board highly recommend this book, but they never really go into why. First off, the first few chapters are essential information while the rest of the book is questions. I did a few of the case studies, but they are kind-of not that great to be honest. Don't get me wrong - I like this book. It teaches you about infection control and priority/assignment/delegation. (No ****, that's the name of the book.) My only complaint is that the patient "sequencing" questions are absurd: When you are asked to order the sequence of patients you'd see, the book would want you to see someone who is pre-op and needs teaching over a critical patient, rationalizing that the critical patient will just "take up more of your time." Overall, this book will teach you how to delegate staff and answer those higher level "which patient should the nurse see first" questions.
Whether you spend more time on content or questions is up to you. I would base it upon what kind-of student you were. Good "memorizer" but poor test taker? Do more questions. Vice versa? Do more content. But for sure search for balance. If you are low on money, buy these books used (even pick up one of those huge question books Kaplan sells). If you spend more than $100 getting these books, you spent too much! In addition, I also made flash cards about things I struggled with (e.g., the fundus), and I created lists (AM/PM/ac/pc/etc. meds; positions; vital signs & labs). Now did all this stuff make me a pro at this test? Hell no. I still walked out thinking I failed. But I went in knowing I had a fighting chance: I knew I could pass - I just wasn't entirely sure I was going to pass on that given day.
Your study plan will vary according to your time, commitments, and obligations, but for me:
Phase One: I started content review (Saunders) before I graduated.
Phase Two: I did four days of another content review with Kaplan's LOD videos.
Phase Three: I did the Kaplan review course over the course of four days.
Phase Four: I did 10 questions in Qbank in the morning to "jump start" my brain before launching into 150 questions (3 x 50 question blocks) and 2 chapters from Priority, Delegation, and Assignment a day. This went on for 3-4 weeks.
Final Phase One: Two weeks before my test, I did Kaplan QT6; one week before Kaplan QT7.
Final Phase Two: The final week I just pounded out the rest of Qbank in addition to those nasty SATA from the Saunders CD. I stopped all studying from the morning of the day before up until the test. If you don't "know" something by then, you won't learn it in a day.
Now some massive insight: Whereas people will ask for advice from those who have passed the NCLEX, I went so far as to also ask advice from people who failed. Learning from another person's mistakes helped me guide my studying. When it comes to the boards, it doesn't matter if you are "smart" or "dumb" Just because you are "smart" or were a "good student" doesn't mean you will pass instantly. "Smart" and GPA are relative. Do you think an A earned at one school is the same as an A earned at another? No way. Even NCLEX passing rates are relative: I once saw a school go from a 100% passing rate to a 80% passing rate the next year. I was like, "How did that happen?" When I looked closely, the year with the 100% passing rate had only ONE student taking the boards at that time; the 80% passing rate had over sixty students taking the boards at that time. Anyways that's besides the point. I would love to properly research the mindset behind first-time passers and first-time non-passers; obviously my "data" is anecdotal, but this is what I pulled:
People who passed. GPAs were across the board; C-students and A-students alike. In many ways, yeah, how you did in school is a predictor of how you will do on the test, but people also get into the "zone" when studying for the boards. They had a steady study schedule. None of them went into believing they were "super-prepared" - none of them came out believing they aced it. Take home lesson? Anyone can pass this test; everyone shares the same anxieties; having a steady battle plan is key regardless of the type of student you are/were.
People who failed. The number one reason was a lack of consistency in studying. They had family obligations that caused gaps in their studying regime. Instead of attempting to study, say, four hours a day, they were doing eighth hours one day then jumping to twelve hours one day with a gap of no-studying inbetween. These people relied way too heavily on rumors and hear-say. They could have quealed all the misinformation bestowed upon them by simply visiting a reputable NCLEX review site (or even the NCSBN site) - but they didn't and believed half the crap they were being spoon fed. Take home lesson? Inadequate study regime with an overabundance of misinformation they accumulated from the internet and rumors.
Closing remarks? The NCLEX-RN is a test written to test minimum competency. And it's a challenge. But ask yourself - would you want the nurse taking care of you to be "smart" enough to overcome this test? I know I would. I hope this information is helpful and good luck with your studies!
