You HAVE to come up with a study plan that will allow you to answer questions, read rationales, and study topics you need to in order to take the NCLEX by the time you want to next. You say you have a problem with focus and fatigue when answering questions, so do them in the morning after waking up. You should be focused after a good nights sleep, don't try and do them at the end of the day when you're tired from whatever went on that day.
You NEED to answer as many questions as you can force yourself to do EVERY DAY. You NEED to read EVERY rationale - right and wrong. Even if you get the question right, read the rationale. You need to read to find out why the correct answer is correct, and why the others were wrong. Also, it is VERY IMPORTANT to pay attention to what it states the key word/subject of the question was. It is IMPORTANT to be able to identify the key word/subject of the question - because it will help you answer it correctly.
Get an app on your phone that has practice NCLEX questions on it, this will allow you to answer questions whenever you get a few minutes, but you also need to just sit and answer a ton of questions. When I was studying, I increased the number of questions I answered each day until I got up to 265. I wanted to be able to sit and answer 265 at one time like the NCLEX. The IMPORTANT thing is to focus on answering as many questions as possible, but also making sure that you read EVERY rationale whether you get it right or wrong - read why each option was right and why each option was wrong. Read to find out what the key word/subject of the question was - read the rationale for that - this will help you to ensure that you are figuring out what the key word/subject of the question was. Being able to find the key word/subject of the question will help you answer the question.
I really liked "Saunders Comprehensive Review for the NCLEX-RN". In the answer section, it provides the correct answer. Then, it provides a good rationale, explaining why the correct answer was correct and why the other options were wrong. It also makes points to state to focus on the subject of the question, and states what it is in the rationale in case you were focusing on the wrong subject of the question - this will help you know whether or not you were focusing on the wrong subject, and if you were, how to figure out what the right subject is. It also points out options that you can be eliminated because they are comparable or alike. Or, options to keep because they are opposites. It also provides test-taking strategy that you can use to come up with the answer (e.g., like eliminating options because they are comparable or alike, or keeping them because they are opposites). It is really helpful to always read the entire rationale and test-taking strategy for each and every question - whether you got it right or wrong. Even if you got it right, you might learn something you didn't know, learn a test strategy that you didn't know about, realize you got the question right but for the completely wrong reason, etc. I think its one of the best resources.
The book "Prioritization, Delegation, and Assignment" by Lacharity is really good! It helps you answer those types of questions, and gives you rationales and breakdown of how to answer it.
"Lippincott NCLEX-RN Alternate-Format Questions". It's really good if you have issues answering alternate format types of questions (SATA, fill-in-the-blank, etc.). This is really helpful because it helps you focus on those questions specifically. It also gives good rationales and breakdowns of questions and answers.
Aside from paying attention to the keyword/subject of the question, I would say probably the MOST IMPORTANT thing when learning to answer NCLEX questions is learning PRINCIPLES and being able to apply those principles. The most important thing is to make sure you know the basic principles. Don't try to memorize everything. NCLEX is testing you on how well you basic principles. NCLEX is NOT testing to see how well you memorized the list of S&S for this med, or the list of S&S for acidosis. You need to know the basic principles, so you can generate the list for yourself based on that. NCLEX is a NATIONAL test, so they have to make the questions fair no matter what book, school, etc. someone went to. Therefore, they can't write questions based on some list out of one of the NCLEX prep books (e.g., Kaplans). The only way to do this is to write questions based on principles to see if the person can generate the answers from the principles. Mark Klimek helps teach this. I would say he was my BEST resource. You have the audios, LISTEN TO THEM, take NOTES over the principles he teaches. He explains things really clearly and breaks things down so its really easy to understand. The way he explained things helped the info stick in my head.
When I say learning PRINCIPLES, here is an example:
So, say a question on the NCLEX says that a pt has acidosis, what S&S will the pt exhibit? Select all that apply. They are testing you on a PRINCIPLE. They do NOT expect you to have memorized all the possible S&S of acidosis. It's IMPOSSIBLE to do that. EVERY book has different lists, of course, most have some of the same things on them, but most also include random other S&S that the others didn't. Since NCLEX is a NATIONAL test, it can't test you on lists, since everyone that takes the NCLEX will have used different resources, and thus, memorized different lists. Which is why you should NOT worry about memorizing lists. LEARN PRINCIPLES!!! So, back to the question, if the question asks what S&S a pt with acidosis will exhibit, what PRINCIPLE are they testing? That in an acidotic environment, chemical reactions cease. So, everything shuts down. You aren't supposed to memorize all the S&S. You are supposed to be able to APPLY THE PRINCIPLE. So, when a question asks you about S&S of acidosis, you know the PRINCIPLE - in an acidotic environment, chemical reactions cease. So, everything shuts down. In other words, as the pH goes down, the pt will go down too (e.g., lethargy, bradypnea, bradycardia, etc.). So, instead of trying to memorize different things, focus on learning the basic PRINCIPLES.
Focus on answering as many practice questions as you can EVERY day, and reading ALL the rationales so you can learn the reasons for the answers. Reading the rationales should also help you learn the basic principles and how to break down questions to figure out the answer.