NCLEX style questions - do you ever get used to them?

Stephalump · Jan 21, 2013

The questions in your book aren't NCLEX style?

Have you thought about buying an NCLEX prep book? I use a few, but the Saunders Comprehensive Review is my favorite.

sofiesgrammy · Jan 21, 2013

Some people get used to them more quickly than others. Here are some tips:

1. Safety 1st! When you read the question, is there an option dealing with patient safety? If so, that's probably the answer.

2. ABC's! Does the question ask anything to do with Airway, Breathing or Circulation? If so, that's probably the answer, in that order.

3. Maslow's hierarchy of Needs. Learn Maslow, you will encounter it continually through school. No matter what you think is the priority, or most important, always order the responses as Maslow would. Physiologic needs first, psychosocial needs later.

4. ADPIE! The nursing process: Assessment, Diagnosis, Planning, Implementation and Evaluation. IF the question is asking you what to do first - the answer is always ASSESS! Pick the option that has to do with finding out what's going on before doing anything else.

5. If there's a respiratory problem, raise the head of the bed and give 2L O2 via nasal cannula.

6. If there's a question about positioning a patient, think about if vomiting and aspiration could happen. If so, lay them on their side.

Hope this helps. Practice, practice practice! Good Luck!

sofiesgrammy · Jan 21, 2013

Just want to add that there are exceptions to what I said above, but in general, these tips are a good way to approach NCLEX style questions.

Don't feel bad, I think most people do poorly on the first few fundies exams. I was an A student, but I had to get used to nursing school and change my expectations. Nursing school is the new normal. I get Bs sometimes now, no matter how much I study, and I do feel that some of it is due to the volume of content we are responsible for, but some is also the darn format of the darn questions.

This is something you cannot change, so find your serenity as best you can!

Maryann Hogan's Comprehensive Review for NCLEX-RN is a great resource. THe book is good, but it also comes with an online access code, where you can take lots of practice exams.It helps you focus on your weak spots by recommending study material based on the questions you miss. It was less than $50 on Amazon.

Hang in there!

nurseprnRN, BSN, RN · Jan 21, 2013

I think you need to step back and see the bigger picture. In my experience the number one reason students bomb NCLEX questions (and their school equivalents) is because they cannot distinguish between two factually-correct answers and think that it's impossible to know that "one is better than the other." This, in turn, is because up until now their exams have all been more fact-based, and all nursing tests (written and the daily minute-to-minute tests you will encounter the rest of your nursing lives) are based on nursing judgment.

And nursing judgment comes from having facts to hand AND being able to apply them as a nurse should, to bring about the best outcome for the patient; the oft-referenced critical thinking skills are new to students, and since they don't come easily, students often throw up their hands in frustration.

You may not have figured this out yet. I think there are two things that are hard, one to learn at the beginning and one that comes on as you progress through the semesters.

The thing you need to learn really, really fast is that everything you learn is something you will need later. It's not like, oh, American History where you memorize the battles and the names and dates, take the final, and you're done with it. In your prerequisites and your fundamental classes you will learn things you will absolutely need to know next semester, and the semester after that, and the next, and for NCLEX, and for the professional work you seek. Be sure that you truly and throughly understand the "why" of everything, because that's the best way to plug it into what comes next.

The next thing is radically different from anything you ever learned before, the "critical thinking," "thinking like a nurse" part. I've been giving a lot of thought to this lately because so many students struggle with it, trying to figure out why this is so hard for them. I've come to the conclusion that in today's short-education world, most students don't get what we got, which was a whole semester course on nursing theories. Do not roll your eyes at me, young man/lady :) -- if a profession doesn't know where it came from, it has a poor chance of knowing where it's going.

If you have the time to study how nursing today came to be what it is, you will have a much better sense of where you fit in to it and how it works, the better to solve these questions. Yes, this means work. Hearing how other nurses who came before us, people like Roy, Peplau, Rogers, Johnson, Orem, and yes, Nightingale and many others thought about what they were doing can give you what they call in the ed biz a conceptual framework to hang your own thoughts on. Pick the one that resonates best with you, and revisit the list now and then to see if it still works for you or something else fits your thinking better. (Nursing Theorists)

The next best thing you can do is be sure to get your NANDA-I 2012-2014 right now, even as a brand new nurse, and put it on your bedside table and read a few pages every night. Really. I mean it. Free 2-day shipping for students at Amazon and you will be sooo far ahead on making nursing plans of care... which depend on, more than anything else, thinking like a nurse.

Now, I know that you have a lot to learn, you are blown away, it is and will be like nothing else you ever studied before, and this sounds like asking too much. But you really asked what would be the best way to acquire this sort of irreplaceable, essential knowledge, and this, in my opinion is it.

springchick1, ADN, RN · Jan 21, 2013

My first semester was Health Assessment and Pharmacology. Pharm test were pretty straight forward (for the most part) but our Health Assessment were all NCLEX style questions. You do get used to them. My grades went up a good bit from the first test to the last. I do study with NCLEX books. I have used the Pearson Review and Rationale book for Pharm and Health Assessment. I won the Fundamentals one but it isn't my favorite. I've looked at and am about to buy the Davis's Fundamentals Success. Someone here recommended it to me and it seems like a really good book.

HouTx, BSN, MSN, EdD · Jan 22, 2013

Do not roll your eyes at me, young man/lady :) -- if a profession doesn't know where it came from, it has a poor chance of knowing where it's going.

^^^^ THIS!^^^^

GrnTea, You're the BEST!

I completely agree - graduates who have been educated in 'accelerated to the fastest route possible' programs are being shortchanged. My organization has objective evidence of this since we utilize a comprehensive standardized assessment for all new hires and have several years of data.

nurseprnRN, BSN, RN · Jan 22, 2013

HouTx, thanks.

I would love to see those data.

bellafsu89 · Jan 25, 2013

Thank you for all the advice! I took my second test and did a skills test too...and its getting better!! I took the advice about ABC's and safety. And actually, the theorists you mentioned were right from our readings and sure enough were on the test!

I also get big time test anxiety and sometimes I can't shake my nerves. I have wanted to be in nursing school for about 10 years and it finally happened...and I have put a TON of pressure on myself to be successful and every test counts so I literally make myself crazy. I think that in a few weeks when I calm down and settle into school, I'll feel better and do a little better too.

I'm studying my butt off to make sure I get all the info into my brain...and I'm learning a ton but not necessarily being tested on it! LoL

Clinicals start Thursday....fun!

aachavez · Jan 26, 2013

Some people get used to them more quickly than others. Here are some tips:
1. Safety 1st! When you read the question, is there an option dealing with patient safety? If so, that's probably the answer.
2. ABC's! Does the question ask anything to do with Airway, Breathing or Circulation? If so, that's probably the answer, in that order.
3. Maslow's hierarchy of Needs. Learn Maslow, you will encounter it continually through school. No matter what you think is the priority, or most important, always order the responses as Maslow would. Physiologic needs first, psychosocial needs later.
4. ADPIE! The nursing process: Assessment, Diagnosis, Planning, Implementation and Evaluation. IF the question is asking you what to do first - the answer is always ASSESS! Pick the option that has to do with finding out what's going on before doing anything else.
5. If there's a respiratory problem, raise the head of the bed and give 2L O2 via nasal cannula.
6. If there's a question about positioning a patient, think about if vomiting and aspiration could happen. If so, lay them on their side.
Hope this helps. Practice, practice practice! Good Luck!

Just had a nursing test taking lecture, and these points were all mentioned. I'd also like to add...

Read the question, and before looking at the options, figure out what they're really asking for. be careful to ignore extra information given thats not needed.

When looking at 'select all that apply'; view each option as a true/false statement. If it's 'true' then it will be one of the selections. Almost always, when there's a 'select all', there will be more than 1 correct answer.

When one answer has words like 'always', 'never', 'only' etc, its usually wrong. Medicine is rarely absolute.

Saunders NCLEX review book is fantastic, and has test taking strategies at the front of the book. Get a review book, a good one, and start practicing questions. Practice practice practice and practice! For some, it takes longer to get better at these types of tests, but practicing will definetly help so much in the long run!

Racer15, BSN, RN · Jan 26, 2013

It just takes time. And lots and lots of practice questions. You eventually get the hang of it, although it won't feel like it. When I took my NCLEX, I was convinced I had bombed it because so many questions were SATA, which I suck at, and I didn't feel that I knew a lot of the stuff I was tested over. But I guess two years of NCLEX style questions being beat into my head worked, because I passed, lol.

flying_ace2 · Jan 26, 2013

For my Fundamentals class last semester, I bought F.A. Davis's Fundamentals Success, 3rd ed. It helped me review almost everything we covered in class (some of it's topics are more med-surg, but that's great because I'll use it again this semester), and it gave me a chance to practice taking NCLEX style exams. It also gives rationales for the correct answers, which helped tremendously. I also found that Saunders NCLEX-RN Exam review book was a great tool for additional practice test questions. Hope this helps - stick with it, you'll get there!!! :)