Here are some things I would like to pass on...
For every question...read the question, read the answer, go back and read the question again and point out in your mind exactly what they are asking. Now go through the answers in more detail.
When looking at the answers look for the following...
Look for definitives...never, always, forever, only, all...as these are frequently a hint that you can rule out that answer.
Remember ABC when it comes to determining which patient to see. Remember that ABC isn't always going to be written in an obvious way so just consider what the specific disease primarily affects.
If you have to do something initially...it's probably an assessment because you don't know what to do until you assess. Always remember that you also need to keep the patient safe so if there's something that is happening that isn't an assessment consider the safety of the patient.
Look to see if some answers are leading back to the same problem with different signs and symptoms and 1 stands out as being a different problem. So maybe there are a few things that happen in a disease but all end up the same thing in the end but there's another answer that stands out as not pointing to the same medical condition as the other 2 answers. If 2 answers go to one medical problem when combined...that to me is a flag that they are wrong.
Really look at the answers and make sure they aren't repeating themselves in an obvious way or in a not so obvious way...low BP but high pulse as these can frequently go hand in hand. Patient with a medical disease that maybe has an abnormal for a regular pt but is a normal for that patient.
Pay attention to what the question is really asking and what the answers really tell you and how they relate to the other answers there. Sometimes comparing the answers will show you that there are 2 that are saying the same thing, are clearly wrong, are normals for that situation.
I found that the NCLEX questions were pretty straight forward and fair (except for meds since you can't learn them all and will probably see meds you never heard of). The rest of the questions they really aren't trying to trick you which is something I felt happened from time to time in school. For my school like liked to provide a ton of information in a quetion or in the answers and you had to figure out what was pointless information in order to figure out what they wanted...NCLEX didn't do that.
Don't answer something until you have double checked what it is asking...what to do vs what not to do, who to see first, who can go where and who can't go.
It's really about the nursing process and knowing the BASICS of diseases.
So this is what I thought and how I approached it.
Practice questions, read the rationales and the STRATEGIES!