NCLEX-RN: A Computer Programmer's Commentary

Students NCLEX

Published

I'll start off by saying I'm not a nurse. I've never taken nursing courses or anything. My wife, however, just completed her RN schooling, took the NCLEX and passed. (We found out about 30 minutes ago) =)

Like so many aspiring nurses, during the last 24 hours following her NCLEX test, she's been a nervous wreck. Being a programmer, I set out to find out what I could about how the test works. I did a few hours of research and presented her with my findings, and she seemed to draw comfort from it. It occurred to me that there are probably many who would like to hear what I have to say. I don't think I have anything to say here that has not already been said, but perhaps my programmer's viewpoint might lend a little more weight to what is said.

My findings are based mostly on technical information posted by the national nursing board authorities, and a little from comments gathered from various forums, including this one. Without further delay, here's what I've found.

The test, as many of you know, uses an adaptive testing technique. The computer asks easier questions when you get answers wrong, and more difficult questions when you get answers correct. In most cases, the computer can figure out with 95% certainty your level of competancy within 60 questions. Since there are 15 "throw-out" questions, this is why most people's tests end at 75 questions. If the computer cannot be at least 95% certain of your level of competancy, it will continue to ask questions. This doesn't mean you are running close to the borderline. It just means that the computer cannot determine your level with at least 95% accuracy. (You could be fluctuating wildly at levels far above the standard. Since the computer doesn't know exactly what your level is, it will continue testing.) If you answer all questions, the 95% accuracy requirement is waived, and the computer reports your level of proficiency as it stands. If you run out of time, but have answered at least 75 questions, the 95% accuracy requirement is also waived.

To find your level of competancy, the computer will keep asking you more(or less) difficult questions until you are getting about 50% of the questions wrong. Let me state this again. THE COMPUTER'S JOB IS TO FIND OUT AT WHAT LEVEL YOU START GETTING QUESTIONS WRONG. This means you WILL start getting questions wrong. You WILL start getting questions about things you do not know. That's what the computer does. That's ALL it DOES. Once it determines within 95% accuracy that your level of competancy is NOT going to change, the test ends. This could happen at 75, or 265 questions, or anywhere in between.

Here are a few conclusions you can come to from this:

  1. The number of questions you received means absolutely nothing. If you get 75, it just means the computer was able to determine your level of proficiency within 95% accuracy within 60 questions(plus 15 throw-aways). If you got more than 75, it still means nothing. It just means the computer could NOT determine your level of proficiency within 95% accuracy, so it kept testing. If you're trying to read anything in to the number of questions you have, stop now. It's useless.
  2. The fact that you felt like you were getting all your questions wrong means NOTHING. This is not a conventional test where getting questions wrong means you failed. The only thing that matters is the difficulty of the questions when you started getting them 50% wrong. If that level is above or equal to the standard established by the nursing authority, you pass. If it is below, you fail.
  3. The only way to determine what level you were at is to know what difficulty level the nursing authority rated the questions you were given. You yourself will NOT be able to do this, because to you, ALL the questions were hard because the computer had found the level that they were HARD for you. The only hope anybody here has of knowing this is to compare notes about the questions. Should you all choose to do this(and many of you have), please keep in mind that you all agreed NOT to share specific questions and/or answers. Please uphold your agreement. Should you choose to compare notes on a vague level, you might all find that certain types of questions are harder or easier. With this in mind, from reading this forum I am starting to believe that math questions are easier, and SATA questions are more difficult. People who passed seem to get questions about infection control, some management, and very specific questions about diseases and meds. This is all just conjecture on my part, however, and I could be very wrong.
  4. The fact that you got your last question right or wrong has no bearing on your result. An incorrect answer could be the one that causes the computer to know with 95% accuracy that your level of competancy is above the level required to pass.

I think I'll stop there for now. Feel free to comment or correct me. I hope this is helpfull to some. Good luck to all of you on your tests. Most people pass first try, but if you do not pass, take heart. Everybody passes eventually, and this test is no indication of your worth as a Nurse. It just measures your relative competancy to a standard. With a little more study, you'll make it. Again, good luck!

Lance...

Very well written and said. You could not have said it any better. You are absolutely correct about your views on the nclex. I too have tried to understand in a deeper perspective of what the NCLEX wants. You know so much about the exam and maybe even more than graduate nurses. I applaud your knowledge on the way the nclex tests. Your post helped clearify some questions I had about the nclex, and also helped relieve some anxiety. Thank you for the great post.

THANK YOU FOR THAT!! i just got home from mine and am feeling that 'pit' in my stomach....

The way you stated how the test functions made me feel so much better!

I appreciate it! And tell your wife congratulations

lancer42

6 Posts

I'm glad it helped a bit. =)

It helped so much that I sent it to my entire family, and all of my nursing friends. That should probably get published cause its the only explanation that i've completely understood :bowingpur

lancer42

6 Posts

Haha... Well, I wasn't the programmer who wrote the software, so the explanation is only as good as my understanding of the facts, but I think it's a reasonably accurate assessment. Again, I'm glad it helped. =)

lancer42

6 Posts

For those that have responded privately and publicly, you're most welcome. If anybody is interested in references to the actual material, please let me know.

Lance...

swirlything

195 Posts

What you wrote is mostly correct according to my understanding of the test. However, the 2009 NCLEX Candidate Bulletin published by the NCSBN and available at the Pearson Vue website, states that "Candidates with very high or very low abilities tend to receive minimum length tests."

Thus according to the candidate bulletin, if you took a 75 question test, you likely did very well or very poorly. This also implies that if you required more than 75 questions, your ability is, in all liklihood, closer to the passing standard than the ability of those who got only 75.

Find the Candidate Bulletin here: http://www.pearsonvue.com/nclex/bulletin_09.pdf

lancer42

6 Posts

What you wrote is mostly correct according to my understanding of the test. However, the 2009 NCLEX Candidate Bulletin published by the NCSBN and available at the Pearson Vue website, states that "Candidates with very high or very low abilities tend to receive minimum length tests."

Thus according to the candidate bulletin, if you took a 75 question test, you likely did very well or very poorly. This also implies that if you required more than 75 questions, your ability is, in all liklihood, closer to the passing standard than the ability of those who got only 75.

Find the Candidate Bulletin here: http://www.pearsonvue.com/nclex/bulletin_09.pdf

Yes, we're saying the same thing in different ways. My point is that you cannot know how well you did regardless. A person who got 265 questions could have been answering questions at wildly fluctuating skill levels, but all of those skill levels could have been higher than the minimum required to pass. Rather than focusing on the number of questions, I feel it is far more useful to focus on the difficulty of the questions you received. I won't restate the futility of trying to do this on your own. My real intention is to calm the nerves of those who think they failed because they did or did not receive the number of questions they expected. =) The bulletin, though correct, causes people to try to read too much in to the number of questions they received. I think nerves could be calmed somewhat by letting people know that this is a test that is setup to make you start answering incorrectly. If you understand that, you will be less bothered by the fact that you were not answering correctly. As it stands, the computer does its thing, people get 50% wrong at a certain point, and they feel like they failed the test, when in fact, at least 85% of them passed. That's a lot of upset, stressed people. Hopefully this thread will help a few of you feel better. =) Again, good luck to all who are taking the test.

Lance...

swirlything

195 Posts

You are right that you cannot KNOW how well you did and that EVERYBODY finds the test equally difficult. However you can, if you get a 75, assume that you did very well or very poorly. You can also know that no matter the number of questions, you have about an 85% chance of having passed.

LEN-RN

164 Posts

Specializes in Med-Surg, LTC, Rehab, HH.
You are right that you cannot KNOW how well you did and that EVERYBODY finds the test equally difficult. However you can, if you get a 75, assume that you did very well or very poorly. You can also know that no matter the number of questions, you have about an 85% chance of having passed.

swirlything - 85%?

Lance,

Thank you for the information. I know it will help ease some of the tension of future testers. You broke it down well. Thanks for taking the time to post this.

Tell your wife congratulations!!:yeah:

lancer42

6 Posts

Yes, but the problem is, everybody thinks they did horribly because they were getting many questions wrong, so they assume they are part of the 15% that failed. Again, the number of questions you received should not be used as an indication of pass or fail status. Question difficulty is ALL that matters.

I'll pass on your grats to the wife... Thank you! =)

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