2nd try failed. need advice

finished all questions with 49%~; redid all questions ended with 70%~. I was 80% confident that I could pass the exam

No surprise that you did better the second time. You answered the questions the first time without knowing the answers and you knew the answers the second time and scored higher. Not a true indication that you were ready for the test. When you got an answer wrong, did you understand the rationale for the correct answer? Ideally, it would be helpful to have a knowledgeable US trained nurse help you study or a tutor. I am assuming that English is not your first language. The NCLEX questions can be difficult to figure out what they are asking for even for US born graduates.

No surprise that you did better the second time. You answered the questions the first time without knowing the answers and you knew the answers the second time and scored higher. Not a true indication that you were ready for the test. When you got an answer wrong, did you understand the rationale for the correct answer? Ideally, it would be helpful to have a knowledgeable US trained nurse help you study or a tutor. I am assuming that English is not your first language. The NCLEX questions can be difficult to figure out what they are asking for even for US born graduates.

Totally agree with above, I know many foreign nurses, who are excellent, that had difficulty passing NCLEX if English was not their first language. Your first score, 49%, is your true score since you were seeing the questions for the first time. That's just not high enough.

I did a local NCLEX review course a month ago in preparation for my own test. Two of best things the review instructor said:

1) Expect the MAX amount of questions on test day, NOT the minimum

2) KNOW your fundamentals. You have been away from school for a long time, I bet a in person review, brushing up on basics would suit you.

So many nurses fail it because they do as you do, focus on hard questions, but he (his review has a 98% nclex pass rate first try) insists that the questions are 1) fundamentals 2) not more than what they actually are. Meaning don't try to add stuff onto the story that isn't there.

The questions are supposed to be aimed at what any entry level med-surg nurse would know. That has helped me not focus in depth in any one condition or waste time. I am in the 90th percentile on U World questions so thus far, his advice has been accurate.

Good luck!

Thank you for your reply. Yes you are both right. I got some questions that I had no idea what they were asking.... I ended with choosing a random answer. Honestly in my daily work, language is still my major barrier.

In terms of the fundamental review course, do you have any recommendation? I do think it will be efficient for me to "repick up" the knowledge.

You may want to find a refresher course that you can take. I haven't taking Nclex yet but am about to graduate and we have used ATI throughout the program and I believe it helps...but it's expensive. It went into our tuition.

Thank you for your reply. Yes you are both right. I got some questions that I had no idea what they were asking.... I ended with choosing a random answer. Honestly in my daily work, language is still my major barrier.

In terms of the fundamental review course, do you have any recommendation? I do think it will be efficient for me to "repick up" the knowledge.

I did my in person review with a local nurse who is pretty popular for it. I would google nclex review programs in your state. Are you on Facebook? Many large cities have FB pages solely dedicated to nurses, you could post there and ask what is recommended in your area.

Try Illustrate NCLEX RN book by JoAnn Zerwekh has good fundamental and med surg summary. Less boring than saunders. I am using it now since I failed multiple times with u world ( I even scored 80% and i failed) ...

I feel you can pass the test. I think you need to make some changes such as during your test week don't work, leading up to the test don't talk or obsess over anything stressful including work stuff and be more confident. You also need to practice and read up on the areas you are struggling with the most. Don't spend so much time on the areas you already know, just review those areas lightly. Don't panic on questions you feel you can't answer, just narrow them down and eliminate the weaker answers. Getting a tutor can help as well. This person may be able to help you spot the issue. When you study questions know all you can about them. Kaplan (I feel it is most up to par with the NCLEX current standards) was my go to but I also used a Saunders book (mainly the CD). Try to have someone you can trust to watch your child so you can carve out more study time and especially during the week you will take the test.

Example --Patient has hypertension, needs medication, should you given a med to bring up the bp or down?, what meds?, (know a few of the most popular ones), when do you check bp again once you give the bp med?, signs and symptoms, what hypertension is and who is risk?, what medications are usually prescribed to treat HTN?, Know what blood pressures looks like for someone with the different levels of HTN (example, pre, stage 1&2 etc)....

I used to write the questions out that I struggled with and key things about the topic.

Know info about all of the options you are considering..

Which family of drugs are the following medications considered: Amlodipine, Verapamil, Diltiazem?

A. Beta blockers (BB)

B. ACE Inhibitors (ACEI)

C. Angiotension Receptor Blockers (ARBs)

D. Calcium Channel Blockers (CCBs)

See above...know all of these meds information--

Answer is B but why?

I feel you can pass the test. I think you need to make some changes such as during your test week don't work, leading up to the test don't talk or obsess over anything stressful including work stuff and be more confident. You also need to practice and read up on the areas you are struggling with the most. Don't spend so much time on the areas you already know, just review those areas lightly. Don't panic on questions you feel you can't answer, just narrow them down and eliminate the weaker answers. Getting a tutor can help as well. This person may be able to help you spot the issue. When you study questions know all you can about them. Kaplan (I feel it is most up to par with the NCLEX current standards) was my go to but I also used a Saunders book (mainly the CD). Try to have someone you can trust to watch your child so you can carve out more study time and especially during the week you will take the test.

Example --Patient has hypertension, needs medication, should you given a med to bring up the bp or down?, what meds?, (know a few of the most popular ones), when do you check bp again once you give the bp med?, signs and symptoms, what hypertension is and who is risk?, what medications are usually prescribed to treat HTN?, Know what blood pressures looks like for someone with the different levels of HTN (example, pre, stage 1&2 etc)....

I used to write the questions out that I struggled with and key things about the topic.

Know info about all of the options you are considering..

Which family of drugs are the following medications considered: Amlodipine, Verapamil, Diltiazem?

A. Beta blockers (BB)

B. ACE Inhibitors (ACEI)

C. Angiotension Receptor Blockers (ARBs)

D. Calcium Channel Blockers (CCBs)

See above...know all of these meds information--

Answer is B but why?

Uhm, but those are all calcium channel blockers, not ACE inhibitors.

The suffixes are typically:

ACE = -pril

ARBS = -sartans

Beta Blockers = -olol

CCB's = -dipine (but there are cardio-selective CCB's like diltiazem)

Answer should be D.