Solid NCLEX strategies

I so appreciated the tips and encouragement here on the NCLEX thread; now that I have passed, it's time to pay it forward!

I graduated Aug. 22, did an in-person Kaplan class Aug. 25-28, then took my exam 2.5 weeks later on Sept. 17th and passed in 85 questions. I worried that it was not enough study time, and it honestly felt rushed a little, but I'm also glad I didn't waste any more days of my life obsessing about the exam and my readiness. So here is the basic strategy that I and a number of my colleagues followed that led us all to NCLEX success.

Make a Plan

I think it's essential for keeping your head during this stressful period. You gotta lay out on paper what you're going to do between now and your test date. Doing this helps you be realistic and also builds confidence in the preparations you are making.

Here are the main points to consider for making your plan:

• How strong am I on content? Have I got a pretty good grasp on these kinds of things?
  
  • ​basic concepts of psych nursing and major mental illnesses
    
  • acid/base balance
    
  • normal lab values
    
  • signs and symptoms of the most common acute illnesses
    
  • major cardio and respiratory problems (COPD, MIs, CHF, asthma etc.)
    
  • major GI diseases (ulcers, Crohn's, ulcerative colitis
    
  • basic nursing considerations for recovering ortho patients
    
  • diabetes
    
  • EKG strips
    
  • basic med-surg nursing actions and procedures (NG tubes, colostomies, lab and diagnostic testing, mechanical ventilation, med-passing, etc.)
    
  • basic nutrition
    
  • basic L & D/ pregnancy/peds
    
  • infection protection/precautions
    
  • legal/ethical issues (basic)
    

  [*]​How do I study best? Is it better for me to go at it intensively and completely for a shorter period of time (sleep, eat and breathe NCLEX), or stretch it out longer and make my daily study sessions shorter with regular life in between?

  [*]​What life factors do I have to consider which I can't change? (i.e. deadlines, financial need to either get a nursing job ASAP or work while studying, wedding or big trip coming up)

After thinking through these questions, sit down and make a plan on paper. We are all different in our needs and learning styles, so don't worry as much about what others are doing. If you have been out of school for awhile or are not strong on content, plan for a week or two of intensive studying to bone up on that via a respected NCLEX prep book or video series or a month at a slower pace. It will take awhile to watch these content videos or go through a content book while taking notes.

If you are pretty strong on content already, then I would say 12-16 days of intensive practice question studying (most waking hours of the day) with a few days completely or half off here and there is a good plan. This will give you time to go through at least 1500 questions with rationales and a number of hours of content remediation and review, which you will still need.

So now, pick a date and register for that exam!

Go with a big-name program

Can you do it on your own? Absolutely you can, if you are well-disciplined.

Do you need to spend that extra $300? No, you don't.

But... this test is really all about strategy, and the big name programs are very, very good at condensing the approach to NCLEX down into effective strategies. For anyone who struggled in nursing school, has English as a second language, has poor recall, has taken months off after graduating, or feels less than confident, I HIGHLY recommend investing in a big-name program and utilizing it to the full.

You really DO need to understand how to approach a question well and apply critical thinking skills to it. And the quickest, most painless route to that is via one of the big name companies: Kaplan, Saunders, Hurst, and there are others I'm not as familiar with. In my opinion, it was well worth the money to be sure I was getting solid advice that was laid out efficiently for me to grasp quickly. Also, if you go it alone, it's hard to know if you are identifying the most important elements to concentrate on; these companies have figured that out already and will guide your efforts in the best direction. I also appreciated the online resource that kept track of how I was doing electronically - very motivating.

Make your study hours count

Now that you are executing your plan, the first thing to do is get those good study habits laid down firmly. You know how to do this; you just made it through nursing school!

• plan healthy, easy to fix meals and snacks
  
• stock up on your favorite study drinks
  
• warn your family/friends/roommates that you're "going under" for awhile
  
• for families especially, make sure kids and spouses know your schedule
  
• get a comfortable space set up that is pleasant to be in
  
• have your favorite study tools close at hand like post-its, highlighters, etc.
  
• take a break every hour for at least 5-10 minutes, move around
  
• exercise regularly each day
  
• sleep well at night
  
• recognize that when you're done, you're done! and you need to take a break! Respect your limits of concentration and do something else to rejuvenate. This is a marathon, not a sprint!
  

Engage with the material via your learning stylesWhether you are directing your own study or taking an online program or class, you have to engage with the material for it to stick. Take a look at these ideas and utilize the methods that really work for you:

• flashcards of meds, med-classes, diseases, procedures, infection precautions, etc.
  
• text-reading with highlighters or sticky notes
  
• taking notes in a notebook as you read, watch or listen
  
• recording your notes or a text to listen to while driving or walking
  
• making up Quizlet decks (can't always trust the ones you didn't make!)
  
• use NCLEX apps on your smartphone
  
• type outlines of material studied
  
• study with friends
  
• have someone quiz you from your flashcards
  
• find extra videos on youtube or khan academy to watch on your subject
  
• draw pictures
  
• look up images of procedures, tools, or apparatus
  

NCLEX Practice Questions - respect the rationale

This is the bulk of what you'll be doing to prepare, and it's important to get all you can from the exercise. It's really important to engage in the material, and not just breeze through it. When you take a quiz or test of practice questions, check your score and take a short break, then COME BACK and start again with #1. Read through every single question and rationale, even if you didn't get it wrong. For many of these questions (you know it's true!) you were just guessing anyway, and you must understand the rationale to make progress and improve your NCLEX test-taking skills.

Also, especially in the beginning, there will be a lot of content to look up. There will be things you have never heard of before and other things you only vaguely recollect. Do NOT make yourself a list of items to go look up later. Why not? Because chances are you will never get around to looking them up. It is better to read your NCLEX question, the rationale, and then go look up that pesky kind of NG tube or weird infectious disease right then and there.

So yeah, if you give yourself an hour to do a 75 question test, then you have to give yourself 90-120 minutes to go back over it and read through all the rationales while taking notes on your learning. This is the program, guys!

I started a document at the beginning of my studying to jot down all the tidbits I learned from rationales and knew I would not instantly retain and remember for life (like 98% of them!). It grew to be something like 70 pages by the time I was done, but it was a superb thing to study from as my test date drew near. It was the perfect document to hone in on all my personal areas of deficit and difficulty.

Build in ample time for review - it's ESSENTIAL!

It's easy to get rockin' on the NCLEX practice questions, taking your notes on rationales and let reviewing what you've learned slip between the cracks. Make sure you build in some time to go back over that huge notebook or Word doc that you've been adding to so that you can review and reinforce all that you've been learning.

Finish the race with grace

You want to be like the tortoise - slow, steady, dependable - and not like the hare - frenetic, wild-eyed, out-of-control - when you get to the end of your studying. Pace yourself by starting with a plan and a good study program, execute it well, then take it easy for your last 24-36 hours before the exam. Many people say not to study the last 24 hours. For me, that would make me MORE anxious, so I was content to take a couple of hours the day before and day of my test (1PM start time) to leisurely look over my notes, but I did stop taking practice questions and I spent most of those days doing fun and relaxing things. It's good advice.

It goes without saying, but treat yourself very well the night before the exam. Watch an episode of Call the Midwife to remember what this is all for, eat a nice dinner, take a hot bath or shower and turn in early.

You can do it!

Yes, it truly is a gut-wrenching, neuron-numbing, painfully anxiety-inducing and outrageous crucible we have to propel ourselves through at the end before they will turn us out into the real world to start our journeys as bona-fide nurses. But you CAN do it. This is certainly a test to prepare yourself for and take seriously. But so much of nursing is reflected in this process of passing the NCLEX, beyond the stress of the actual questions, that is good to bear in mind. We do need to be well-educated in basic nursing knowledge and practical skill; we do need to be critical thinkers who can apply our knowledge with intelligence and flexibility; we do need to have stamina and keep a sense of our selves even in the face of difficult challenges. So as those dreaded SATAs come rolling at you, just keep all of this in mind, take a deep cleansing breath and keep moving forward. You're gonna be a nurse!