2014 NCLEX in 75Qs...my (long!) tips

Nursing Students NCLEX

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Hi All!

This board was such a helpful resource in nursing school and while preparing for the NCLEX. I really appreciated when people reported on their experiences and how they got ready for the exam, so I wanted to do the same.

I passed the NCLEX in 75 questions on 2-4-14, after graduating in Mid-December. I was pretty happy leaving the test, got the good pop-up, and my license was posted yesterday to the BON.

The test itself:

-In a post here, someone described the NCLEX as both harder and easier than they expected. While that drove me crazy, I now understand! The test asks you to think in challenging ways, but the information you need is not obscure or specialized. This is a general test for a generalist. So, while it is good to review everything, spend your focus on concepts. For example, when you are reviewing vitamin deficiencies, I would not worry about knowing the difference between dry, wet, and infantile beriberi. I would instead focus on what thiamin does in the body and what a deficiency would generally do.

-There was a TON of SATA. I was praying I would be one of the lucky people who had only 5 or 10, because I couldn't imagine doing any more than that and passing. SATA was far and away my weak spot. (For those of you who used the Kaplan Qbank, my SATA test score (test #3, maybe?) was a 38%! Yikes!) However, I found that the SATA on the NCLEX was much easier. Again, it was based on concepts and critical thinking as opposed to rote facts. So glad I knew about those going in, though-- I feel like SATA is such a small proportion of the questions both in school and in test prep, I never would have expected so many and would have been very flustered. Bottom line, if that is what is making you nervous, relax. If I can get through them, you certainly can!

-Know how to prioritize and to delegate. Again, something that wasn't proportionally stressed in my program or review materials. However, it makes a lot of sense-- a brand-new nurse really needs to at least know the principles of how to do this!

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How I prepared:

-In school, we used ATI for every class, and extensively in our final semester. We also had to take 2 predictor tests (99% and 97% for me). I don't think ATI is really comparable to NCLEX, but it was good for general material review and for training in NCLEX-style thinking.

-Our final semester, we were required to do 1,000 questions on the Saunders CD. I did about 700 on my own after graduation (including all the alternate questions). This was good when I was too tired to focus on anything else, but much easier than the actual NCLEX. Rationales were helpful for content review and showing me weak spots.

-I bought and used 100% of the Kaplan Qbank. It was very expensive, but re-taking the exam is expensive, too, and more importantly, my nurse residency start date was riding on passing the exam by a certain time. So, for me, the expense was 400% worth it. I did things only in timed mode, and did 50 questions at a time, all mixed together. My qbank average was 64%, and basically stayed around there the whole time (some 58s, some 72s, but mostly 64%. Again, for practice test 3, the all SATA one, I got a lousy 38%!).

-I used the Kaplan review guide that is free for Kindle on Amazon, because it was concise and the right level of detail for me-- enough to remind myself of the concepts and information, not so much that I was overwhelmed. I don't think it was that strong in reviewing the disease processes/mechanisms of action (which are so helpful in critical thinking) but does do a good job with procedures, protocol, and interventions. It's also easy reading, so I didn't feel like I needed to be locked in the library to really soak it in.

-I also used youtube and some other internet resources to review. Youtube was awesome for ways to remember things and for helping me to visualize procedures.

-I read every rationale. I also kept a running list of questions to look up. I made sure that I not only understood the right answer, but also why the wrong answers were wrong. So, if the answer was right-sided heart failure, I made sure I also knew why it WASN'T left sided heart failure, and what left-sided heart failure would look like (in my head, I always ask: How would the question need to be written so that the wrong answers are right. Not sure if that makes sense to anyone else!).

My Random, Lengthy Tips:

I did a lot of things "wrong" in my NCLEX prep, but they worked for me. My biggest advice is to know how you learn and don't fight against yourself! I think it is easy to feel overwhelmed reading these boards and seeing the many different strategies people have used. I also think the sheer number of different commercial study programs and resources available makes it hard to know where to start. For example, studying for 10 hours for 6 days before an exam works better for me than doing it for an hour a day for 6 weeks. In school, it was a better way for me to learn, and it helps me to retain the information when I completely submerge myself in the material for a period of time, living and breathing it and blocking out the outside world for a period of time. Again, against all advice I've ever had!

-Don't let the perfect be the enemy of the good. One of the reasons it took me so long to begin studying is I felt overwhelmed. I had this idea that I was going to re-read and take notes from the ENTIRE yellow Saunders book, and read a separate review for pharm, and do all of Kaplan (getting in the 80s on all tests), and all of this other stuff. Worrying about being the model NCLEX student made me too scared to start. So, guess what? I ended up reading the much shorter, simpler Kaplan review, studying pharm by making flashcards in front of Keeping Up With The Kardashians, and starting most of my studying mid-afternoon. I told myself I was in it to feel like I was 80% prepared, not 100% prepared. When I tried to really know everything, I felt so stressed and terrified, and it felt like the work would never be done.

-If something has worked for you, trust it. I know things like decisions trees really can help some people, but I was worried it would confuse me. I'd done well in school, so I decided that even if there was a theoretically better approach to NCLEX questions, learning it would probably only confuse me.

-Listen to yourself, within reason. I was advised to take the exam ASAP, that scores drop significantly the further you get from graduation. I was one of the last in my class to take the NCLEX, around 7 weeks after finishing classes. I took a full MONTH off from even looking at nursing stuff, I was so burned out by the end of my accelerated program. I would try to open the book and end up feeling so unable to focus or retain anything that I just put it back down. I caught up on sleep, saw friends, celebrated the holidays, and finally read a book for fun! Once I really felt healthy and well and like "myself" again, I found it much easier to come back to the information, and was shocked and pleased to realize just how much I had retained and really DID know! If my brain hadn't been rested, I don't think I would have done as well.

-Know what to expect. I went to the testing center before the exam to know where it was. I had read on here to remember to ask for earplugs (something they did not offer to me, and had to go into a drawer to get), that I could have breaks, that you get a white board instead of paper, etc. That was a BIG reason I bought Kaplan-- I wanted to be used to what the exam looked like. I think it really helped to feel the screen was familiar- it helped me to feel like it was just another practice exam, not a big scary test. I can't stress enough how much those things helped.

-Study where you feel comfortable. Some people say to make sure to go to the library, etc to get a sense of the real conditions, but I ended up studying for the whole thing on my bed, usually with my boyfriend on his computer next to me and the cat at my feet. When I began to feel anxious during the exam, I closed my eyes and imagined being right back there, where I felt safe and calm.

-TAKE IT SLOW! I knew my weakness was rushing through the questions when I got fatigued + started to feel stressed (one or the other i'm still ok). I'd think I knew what the question was asking, but be wrong (so, idiotically missing "requires more teaching" and happily picking the statement that shows the patient understand, not the right answer that shows the patient does not understand). So, I was VERY deliberate to slow myself down. I read every question veeeeeeery slowly to myself and sat and thought about it. It ended up taking me an hour and a half to finish 75 questions, which is about double the time I'd have expected based on other exams.

-Check in with yourself during the exam. Are you feeling tired? Rushed? Jaw clenched? When I caught myself speeding through a few questions, I stopped, closed my eyes, and took a full 60 seconds to regroup and relax.

-Know the patho. Patho saves my butt time and time again. A good understanding of how the disease as a whole affects the body really helps in figure out your sickest patient and makes a big difference in critical thinking questions. Know what the worst-case scenario is. Know what the treatment is and what is does that makes it effective. For every disease, you need to think, "ok, what would a turn for the worse look like, and where would that lead? Now, what would I do to fix it?"

-Stick to the basics. Life over limb, etc. When I get a priority question, I usually think, "Ok, if sh*t hits the fan, who would die/who would die FASTEST?" So, both people might be dying, but the person who could die in 15 minutes wins over the person who could die in an hour.

-Don't miss the low-hanging fruit. Know how to calculate dosages cold (it may take trying some different ways...I was never taught formula method, for example, but it's the easiest for me and gets me the right answer every time). Memorize your lab values (don't worry if one says 11.8, and another says 12. That used to drive me crazy, that the lab values are different depending on the material, but nothing I saw was every so slight that the variations mattered). Know how to identify a rhythm and read an ABG. Basically, if you can get the answer by simply knowing an often-used fact/formula/pattern, learn that!

-Take the SATA's as true/false. This was really helpful for me during the test, even more than it was when I practiced.

-Really do take the day before off. And have something fun planned after to look forward to!

-Lastly, NCLEX studying should be a REVIEW, not a RELEARN. I needed to trust that I actually did know these concepts, and knew them well; studying was to brush up, keep some details fresh, and go back to thinking in "nclex format". That being said, I know it is easy for things to get missed in school, so for people who really do feel weak on content and concepts, give yourself a break from worrying about the NCLEX and take a review class, use a tutor, work with a study group. Studying for NCLEX isn't fun, but it shouldn't feel overwhelming and confusing-- give yourself the time and knowledge you need to feel ok.

For those who are still in school, thinking ahead to the NCLEX, the more you throw yourself in now, the less painful and stressful it will be later. Most of my preparation was simply doing well in nursing school-- I really didn't prepare all that much for the exam itself. In nursing school I studied for every exam by doing practice NCLEX questions, did tons of ATI practice tests and tests for classes, and was required to do 1,000 questions from Saunders in my last semester, as well as 8 different ATI tests and 2 predictors. (99% and 97%).

Good luck! it is not something you can blow off, but the exam is doable and anyone who cares enough to be on this board looking to improve and succeed is off to a great start

I love it!!! You just said something that drives me nutts!! Those darn lab value ranges that change per book/manual OMG!!! I just told myself today to let it go because the variations wont matter much pertaining to the test just pick a book and go with those ranges. When I first started studying for the test, I too was overwhelmed. I didn't know where to start, but I got it together after focusing and writing down questions of things I knew were my weak points. I told myself I know my content and I will focus on the strategies along with my knowledge base. Thanks for sharing your experience with us!!! Congrats to you!!!!:cat:

Thank you for sharing this WONDERFUL post. & CONGRATULATIONS New RN!!

PCTerrific, how did you get passed the nerves beforeband? Cause that seems to be my biggest downfall :-/

Thank you for sharing! This is very helpful. Congrats! :)

Thanks for sharing. Congrats to you!!

Hello

congrats what youtube did you search for memorizing labs can you please share? Thank you

Congrats!! I read your tips after not passing on 1/8. Took it for the second time today, shut off at 75q and good pop up!! :) Like you, I tend to rush, so refocusing myself and realizing how I was feeling really helped. I would also add the Lacharity book on prioritization and delegation is immensely helpful!

Thanks for sharing! I have eight days until I test and I am utilizing Hurst materials and purchased the LaCharity book also. People seem to swear by the book. I am super nervous, any tips on that?! ;)

Great job Jackic. Can't wait to share my story in 8 days. Fingers crossed :)

Specializes in Psychiatri.

Thank you for sharing this! I found this very helpful! Congrats to you passing as well. ;)

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