BrentRN

The current test has not changed at all. The COVID changes are just the removal of 15 questions that are tested against the applicants other answers for determining difficulty level. The difficulty level and passing rates are comparable to the scores of Spring 2019. If you are referring to the Next Generation NCLEX or NGN, that does not go into effect until 2023 at the earliest. Also, the NGN questions will just be a set of questions added to the current test. The NGN questions are a group of 6 unfolding case study questions that are variations of existing NCLEX style questions. The group of 6 will not be adaptive like the others as there will only be one case study per group.

Please know that you can fail 50% of the questions and still pass. Unless you got them mostly all wrong you probably passed if it stopped at 62. The failed payment trick is not always reliable. Try going to your state board of nursing site to search for licensed people. In some states you will see your name very soon after taking the exam.

I think you are mixing up what nursing instructors and NCLEX-prep resources do to try and prepare you to be be a nurse and pass the boards. Nursing instructors are trying to prepare students for more than the exam. The exam only tests minimum safety by a new nurse. The nurse prep resources are just guesses based on the standards posted by the NCSBN. The questions themselves are highly secret so anything you see outside of the NCSBN site are just guesses as to what is on the test. Some resources are much better than other. The NCSBN says that all questions are higher level, i.e. analysis and evaluation measures. By their nature they will not be a question about a fact, it will be a question that requires you to apply your knowledge and make a judgment about care. For example, a question about a client on Dilantin asks about nursing care needs would give 4 options. The correct answer would involve providing careful oral hygiene. This is a question that may seem "tricky" until you remember that Dilantin causes hyperplasia of the gums. Dilantin is a seizure med but this is testing your knowledge at a higher level, and your ability to provide a higher level of care. I hope you can see that the question is not trying to trick or confuse but, rather, to test a student's ability to think beyond recall of a fact.

What is the source for this question? Unless it is from the NCSBN site this is not an example of an actual NCLEX question.

I am not sure how the low percentage is due to the unions not doing a good job. There has been a systematic effort to kill unions in business for the last 45 years. Entire business are out there to help businesses keep union away. Employees will be told the dangers of unions, with pleas to not let them come between the employees and the beneficent employer. If you want to get better working conditions just start talking about starting a union. Suddenly, benefits and other perks will appear. I have seen it happen several times in my career.

Are you referring to actual NCLEX-RN questions or those found in prep resources. Those are two different issues. Assuming you are referring to the actual exam, it reminds me of the questions I wrote for exams that require application of knowledge rather than recall of facts. Some students struggled with those and claimed I was trying to trick them. I think that comes from too many students being tested on recall rather than comprehension in their academic careers.

Excellent response. I have worked in union and nonunion environments. In the nonunion meritocracy workplace I saw raises distributed at the whim of the supervisor. Those who curried her favor got more money each year. "Merit" raises need to be based on measurable outcomes. A union can help make sure that happens.

To all nursing students: If you think a faculty member has a bias due to your race, gender, or sexuality you should document in a diary format what you consider biased behavior. There may not much that can be done unless it is blatant. Ask other clinical group member to corroborate what happened and record their names in the diary. You may have to make a call whether to complain during or after a semester. Personally, I would first discuss the concern with the faculty member. If you have documented what you feel is her bias then bringing it up to her may make her aware of an unperceived bias. You also have protection from retaliation this way. If she tries to lower the boom then you have evidence in your diary, and the fact you tried to address with her first. If direct communication fails then take your concerns to the next person up the ladder, which is usually the Department Chairperson. Do not jump to Deans or Presidents without first going through your local chain of leadership.

All healthcare shortages in the US are mostly a problem of distribution not numbers of available providers. We have a rural/urban divide in our country's politics and choice of home. The educated are more likely move away from rural areas leaving fewer to care for those who remain.

Their reported reason for doing it is that something like 50% of all nursing errors are committed by first year nursing students. They have concluded, without published evidence that I can find, that the licensure exam must be to blame. The long stated purpose of the exam is to assure the public that the candidate can perform safely at the level of a beginner nurse. That is all that it tests. It does not test all the other things that make one a good, well-rounded, and well-educated nurse. An expectation of safe practice is the ability to critically think in nursing situations. Safe nursing obviously is more than efficient task performance. ADPIE is a tried and true way to guide the beginning nurse through clinical judgments. Unfortunately, many nurses do not recognize they are using a nursing process, or what framework guides their practice. The dirty secret of nursing is that there is not one universally accepted definition of nursing. There are lots of competing and overlapping definitions but none that succinctly capture the roles of the nurse. That is the reason we live with so many competing frameworks, and nurses who cannot define basis of their practice.

You're absolutely correct, yet the NCSBN touts their research as the reason for going ahead with the changes.

I am not sure of what you are asking here. Please elaborate. Thanks.

A few commenters feel that requiring graduates to take an exit exam is "manipulating statistics". I think I understand what they are getting at because they feel a passing rate should not be affected by an exit exam requirement. Based on the many statistics courses I have taken I don't think that qualifies as statistical manipulation. Statistical manipulation means altering your data or presentation of the data to show it in more favorable or misleading light. Manipulation of a passing rate is actually not possible because the data is provided by the State BON not the school. The state just reports the passing rate of candidates as they take the exam. I have taught thousands of nursing students at three different nursing programs over a 30 year period. Nursing schools face a great challenge of setting a floor for what is acceptable minimal level of mastery. A school can set a bar very high and only allow the very top scorers to graduate but then the school will criticized for high attrition. They could also set the bar very low and then have angry graduates who are incapable of passing the NCLEX or getting a nursing job. Finding that sweet spot is very challenging. Just one problem is that you have different faculty creating different exams of different difficulty levels but all are using the same cut score. When you have to stick to the cut score you get issues where someone gets to pass by a rounding error along with a better grade on one paper. The student would be better served by repeating the course but rarely choose that option. They then get to the next semester and continue to struggle but either fail or just make it. Remember that in all groups somebody has to be below average by definition. Nursing curricula are not designed just to pass NCLEX. The exam is just a minimal demonstration of safety using a testing methodology that cannot be fully duplicated by any nursing school (Computer Adaptive Testing). Exit exams are just an attempt to prepare a student for a type of testing they may never have experienced. For example, teacher prepared exams are still done on paper where the whole exam is given to the student at once. A computerized test only lets the student see one question at a time. The ATI, HESI, Kaplan and the like are simulating that testing method. That seems like a reasonable and responsible thing for students to experience before going to the NCLEX. In an ideal world all graduates should walk out of school and pass without an exit exam. The national average for first time test takers without test preparation is around 85%. Some preparation for the exam can put the passing rate above 90%. While some folks in this discussion see that requirement as a disservice, my experience is that students have thanked us for being sure they are ready. Another issue is that I have had students in the past take the exam without studying "just so I could see what it was like". My fellow faculty and I were aghast at that view because so much rides on first-time passing rates. To summarize, I don't think an exit exam is a "manipulation". It is just a preparatory requirement right along with passing all your other requirement from Art to Physiology.

I think it is a good thing to try and improve the exam. The tested NGN questions are not problem. The problem comes from creating the questions before validating the CJM. The council claims the model was validated via an expert review but that is an inadequate method for a model that has far reaching effects on nursing education and practice.

The problem is that the tested questions are simultaneously assuming the CJM is valid and that the questions validated the CJM. That is circular logic. Imagine this analogy: Suppose I have a theory that homeopathic medicines are using "quantum level force" that cures headaches. I then give my headache patients the medicine and find that about half the time the headache goes away within a few hours. Did I just prove "quantum level force" cures headaches? Of course not. Without a mechanism for how the force relates to headaches just showing good results does not confirm the force exists. This is just why the NCSBN cannot say their research is validating the CJM. The other problem is that the secrecy of the NCSBN keeps anyone from seeing their data, or even discussing their methods. We are just supposed to believe them but that is not how science works.

The issue here is that the NCSBN has conflated two issues. The first is their ongoing efforts to improve the NCLEX-RN exam's ability to identify a safe, beginning nurse. Licensure was first done with paper and pencil tests on five areas of practice that was offered twice a year. In the 1990s, Computer Adaptive Testing was implemented to allow year round testing and to achieve reliable testing results with a minimum of questions. Since that time the NCBSN has been trying to go to a richer testing experience. They have been talking about using case studies and more intelligent computer analysis of answers but have not gotten far. A few years ago they launched their NGN initiative. It is attempt to have the candidate progress through a case by demonstrating mastery of the parts of the nursing process. The new question types being tested are mostly extensions of the current alternative question types that have already been in use. The trouble has come from the second effort of the NCSBN to declare a clinical judgment model as "driving nursing practice". There are several problems with this approach. 1. First and foremost: The NCLEX-RN should be REFLECTING nursing practice not DRIVING it. The NCSBN needs to examine what and how nurses think, and only then create exam questions to test that ability. 2. The CJM was created through a quick literature review and synthesis of existing models without first testing the validity of the model. The model may be perfectly fine, but that is not how a model with such far-reaching effects should be put into effect. Any proposed model needs to be looking beyond the few sources they cite, collecting qualitative data from practicing nurses and faculty, and then proposing a model. The model would then need testing of its validity. 3. The CJM seemingly has ignored literature on the simultaneous use of analytic and intuitive thinking. The NCSBN has just created another linear thinking model with different labels and no validity testing. 4. The NCSBN continuously conflates NGN testing with the CJM. They seem to be using a circular logic that the CJM guides the NGN which validates the CJM and NGN (my head is spinning writing that). The NCSBN is well funded and secretive. They have taken a paternalistic "we know best" attitude so far to any criticism of this process. There are good reasons for test security but they need to be more forthcoming with the process of test creation. Major changes to the NCLEX-RN will mean changes in nursing schools to nursing curricula, pedagogy, and evaluation. These will all cost money and time. It is clear that many people and organizations are ready to cash in on this change as it rushes toward implementation. It is time to slow down this push to change the basic view of how nursing judgment works and proceed in a more scientific manner.

This topic may seem arcane to the average nursing student but it is important to learn about. I recommend nursing students talk with their nursing faculty about this issue when they return to school. The National Council is changing the exam and changing the foundation the questions are built on without research to support those changes.

An interesting hypothesis. I think the NCSBN should do post-test research on candidates' state before and after the exam, and how they may correlate with success.

This has become a long thread but we need to remember that the rules were instituted to appease those who wanted others to tolerate their intolerance.

You can receive a reduced SS benefit at 62. 67 is the age for "full benefit" but it continues to rise each month you delay until you are 70. You have larger monthly checks but you have to live long enough to get back the money you deferred.

As a nursing student in the 1970s I had an instructor flat out tell me she did not think men belonged in nursing. We were "taking jobs away from women". That was at a time when it was harder for women to break into professions outside nursing or teaching. Sadly, I have continued to meet nurses who hint they believe women are more suited to be nurses as they are more likely to have the correct "worldview", have greater empathy, or still think men are taking all the top jobs.

That's why I said "you most likely passed" and not "you passed". The vast majority of 75 question exam takers passed.

Use Pinocchio to help you: Conscience = Jiminy Cricket Conscious = Pinocchio after he became animate

Some points of clarification: References to a god or higher power are only found in the Declaration of Independence but there are none in the US Constitution. The Declaration has no legal bearing. In God We Trust started appearing during the Civil War. It officially became the US motto in 1956.

The issue is not the choices of our patients. If an adult chooses not to have a hearing test due to a religious reason that is their right. The issue is what nurses should be doing with ethical dilemmas regarding patient care. If a Scientologist goes to work in a psychiatric unit, or a Jehovah Witness goes to work in a blood bank, or a Christian Scientist goes to any healthcare facility I think they would harming their own faith and the health of the patients.