On my first attempt, I used the Saunders review book and the Q&A flashcards. Read through the whole book twice, completed the 5,200 questions and 1,200 flashcard questions. Took the NCLEX and failed at 114 questions.
Second attempt was yesterday, AND I PASSED! I am so incredibly happy and relieved right now. This time I got 193 questions. It felt like a different exam, a considerable number of the questions including the majority of SATA's were leadership/management or general concepts. Not nearly as much patho like on my first attempt. Still, there were many, many prioritization questions and ~10 drag-and-drop or diagram questions in total. A lot of OB too. Lost count of how many SATA's there were early on but estimating around 40. The last three questions were SATA back-to-back-to-back. The last question was about blood transfusions and I spent the whole car ride back and rest of the day lamenting over whether I selected the correct adverse reactions lmao, even though it should've been relatively simple in theory. Once the question #'s got in the 150s I predicted it was going to go to 265 but was pleasantly surprised.
Anyways, I relied on UWorld this time around and it was honestly my saving grace when it came to the NCLEX. The questions are so similar to the actual exam unlike Saunders, for example which patient statement indicates adequate teaching or requires follow-up, the alternate format questions, and most importantly prioritization - both the nurse's priority action or which patient to see first. I've completed the Saunders test bank and skimmed through other resources like Kaplan, Lippincott and thePoint online, and while they may be helpful for content review, there is no matching the similarity of questions between UWorld and the actual NCLEX exam. If by chance someone just came on here about to start preparing for NCLEX and was debating on which resource to use, I would highly recommend UWorld. Also, don't get discouraged if you score low percentages - my scores were low as well. I completed the first assessment right off the bat and scored a 42% (2% chance of passing, yikes). Proceeded to the test bank, completed all ~1960 questions with 52% accuracy. Then I retook the 900+ questions I got wrong. Finally completed the second assessment and scored a 62% (77% chance of passing). What matters the most is reading every rationale and trying to understand the concepts of why 'x' is the right answer choice and the others are wrong.
A couple tips I'd like to add:
Pace your studying.
Did a 75 UWorld question set per day. Going back over every rationale and trying my best to understand. It's not about the quantity but the quality of review. I also copied the graphics and noted some rationales I thought were worth looking over again.
Take your time on the exam.
There is a maximum of 6 hours allotted. Say you even get all 265 questions, discounting a couple minute breaks, that's about 1 minute 20 seconds you can afford to spend per question. Many times doing practice question sets I'd submit and review it only to scratch my head and wonder how I answered it the way I did - often times I misread the question or rushed through it without properly analyzing the situation. Read each question and answers carefully and reread them. It can also help to read the question first and take a couple seconds to think about how you'd respond before looking at the answer choices.
Use breaks to your advantage.
Don't hesitate to take them or brush it off as not important. More often than not there is plenty of time to spare too. The one regret I had on my first attempt, aside from lack of better preparation, is that I didn't take a break during the session. The questions in the 100s felt like a blur and I probably missed the majority of them and one part would be losing focus. The NCLEX can certainly be mentally draining and fatigue is factor, but you want to be at the top of your game for each question. Every 40 or so question I would close my eyes and take a couple deep breaths before moving on. After I got to question 76 and saw the exam was going to continue, I immediately raised my hand and went outside to do some jumping jacks to get the blood pumping again. It was honestly so refreshing.
Prioritization will most likely be the single most tested topic on the exam. Whether it's giving you a scenario and asking which nursing action is the priority, or which patient to attend to first with various presenting signs/symptoms, or which patient after surgery to look at/return a call first etc. Also, psychiatry-related or patient safety. Remember the ABCs (airway, breathing & circulation), Maslow's Hierarchy of Needs, and the steps of the nursing process. A question to ponder is, What's the worst-case scenario if this patient does not receive immediate treatment/intervention?
Maintain a positive attitude and mindset.
This can go a long way towards preparing for the exam and day of. Trust in yourself and your knowledge!
I have attached a little reference guide here, including fluids & electrolytes, lab values, and medications below. By no means is it complete though, just in case it helps.
Flashcards found here may be helpful as well: NCLEX Study Sets and Flashcards | Quizlet
Some people breeze through the NCLEX and whatnot no problem. I am someone who struggled mightily through nursing school, as in having failed OB the first time around and was one point from the final away from failing the med-surg course. Was so discouraged after failing NCLEX on my first attempt but somehow I made it past this hurdle. This might sound clichÃ©, but I genuinely believe - if I can do it, you can do it too. Anyways, sorry for the long *** post. If this could help just one person out there it's worth it! Best of luck to everyone still preparing for the NCLEX.