TIPS/Info for passing NCLEX

**SKM-NURSIEPOOH, BSN, RN** · Nov 8, 2004

First off...I had 75 questions & passed the first time out. I got one of those 'check all that apply', four of the med cal where your 'fill-in' the answers, & loads of delegation / prioritization / therapeutic communication. I had none of the 'putting the answer choices in numerical order' or 'clicking on the graphical picture' questions either...That god!

I've purchased a few testing tools...Mosby's online cat & their NCLEX-RN review book/cd...But didn't like it. I found their website not so user friendly & their NCLEX-RN book to have the same old comprehensive questions that I got in school. It had none of the so called 'new integrative' questions. So I did take the Laplan review course at the advice an professor because they did offer the new style question in their review...& I'm glad that I did. I'd learned in their course that many lpns & graduate nurses who work prior to taking the exam fail the NCLEX-RN the first time out. Said individuals fail due to answering question based on 'the real world' instead that of the "Perfect NCLEX-RN world!'

I went with Laplan's NCLEX-RN online review & q-bank where I worked at my own pace...It was expensive as hell ($418.00 plus s&h)...But well worth it...Considering the amount of money put-out for my nursing education in order to further my career! They had literally thousands of exam practice questions...Both in the book, online, & on cd. They also review these questions after you've taken their practice tests. They also have video seminars that also go over these exam questions with rationales. Sometimes...It helps to have the rationales verbalized & not just written when you go to review each exam. And then they also have video review on such topics as assistive devices, chest tubes, ng tubes, etc.

At the risk of 'giving away' some *secrets*, Laplan mainly stress how to read the questions properly & how to answer & how *not* to answer them. They suggest that you read the question once, don't predict or look for the answer before giving all of the choices a review. Don't answer questions on a hunch or feeling...But have confidence in what you do know as a graduate nurse! They stress that recall or recognition & comprehension questions are *not* the minimum competency question required to pass. They stress that assess & analyses questions are of the *critical thinking* & therefore considered above the competency passing level. No matter how many questions you answer, 50% of the questions you do answer have to be above that minimum competency level. Once you've done that, the machine will cut off on you. Mind you, 15 questions will be *experimental* questions & you can literally pass the exam having answered 50% above competency level with 60 out of 75 questions overall.

The test is designed to start-out at a medium level questions .... Question right at the minimum competency level. Keep in mind...The more questions you've answered correctly, the more difficult the exam questions are suppose to become! You'll notice they'll go from comprehensive/recollect to the assessive/analyses types. So you'd really want to walk away from the NCLEX-RN feeling like that was the hardest exam ever! That *is* a good sign! There are several ways of passing & failing the test.

Answer 50% question above competency minimum by the 75th question & the machine will cut off & you've passed.
Answer 50% question below competency minimum by the 75th question & the machine will cut off & you've failed.
Answer strings of correct answers at or slightly above the starting medium level question...then start answering string below that level. This will cause the machine to continue to give you more questions in order to give a chance to redeem or prove yourself...if that's the case, then you've passed...but if you don't, then it's a fail. This can take you through to question 265. again, if you answered 50% above or below the minimum, the machine will cut off... it doesn't matter whether you've got the last question right or wrong either.
Should you run out of time before you complete the exam, the machine is program to look at how many you've answered correctly towards the end. the only way of passing the exam is to have the last 60 question answered correctly in a row...which is every hard to do.

Kaplan then teaches you to decide if the question has enough info in the stem to warrant implementation...If not...You'll have to assess further. Stick with the nursing process model...Assess prior to planning, implementing, & evaluating. Should the stem of the question give you enough info...Then the answer will be an implementation. If the stem of the question is vague, then your answer will be an assessment. Also, you have to remember Maslow's hierarchy of needs & where the physical needs supercede the psychosocial. For the purpose of the NCLEX-RN, pain is considered a psychosocial rather than physical need.

That said, some questions will have all assessment or all implementation as answers. In this case, you'll have to go with the *best* answer. How to come-up with that is by process of elimination. Read each answer & ask yourself...."What will the outcome be?" "Is this a true statement?" if it is...Then consider that answer response...But if it's false...Then throw it out. "Does it follow the ABCs?" when following the ABCs... "Will the answer choices make sense?" I.E....If the question is based on a circulation problem & you see a resp & a circulation choice among the four answers...Then by all means pick the circulatory answer because it fits with the stem of the question/situation (use your common sense or *critical thinking* skills here). Ask yourself..."Would a prudent nurse do this or not?" oh & when you see a question that suggests "Further teaching is necessary" or a senrio where you the RN know an uap or a lpn is performing something inappropriately, then you'll be looking for an answer with a "Negative" or "Wrong" statement. Read each answer & ask yourself..."Is this a true statement?" & if it is...Then throw that statement out.

As far as delegation, Kaplan stresses that the RN is ultimately responsible for all tasks delegated. Now I know from experience, lpns can be given a lot of tasks that require assessment/gathering, planning, & evaluating loads of information...But in terms of the NCLEX-RN...They can't do any assessing, planning, evaluation, or initial teaching. That is entirely the role of the RN on that exam! Also, lpns can only be given patients that are hemodynamically *stable*. They can't be given any patients that require constant monitoring for evaluation purposes. Lpns are only allowed to implement written orders from mds/apns & follow instructions given to them by the rns in charge to cover their patients. As far as the uaps (unlicensed assistive personnel)...They can only be given the most basic of psychomotor nsg tasks like taking vital signs on stable patients...Assisting with adls & ambulating patients for therapy & again...No assessing, planning, & evaluation...Etc.

Another thing....Mds/apns/nsg mgt/other interdisciplinary dept/personnel such as msw/chaplins/resp/occup/physical therapists are *always* available to the NCLEX-RN staff nsg! These people are multiple & fruitful...But remember this.... *do not pass the buck to them* ! You have to assume that there are standing....If not written orders for your patients... Remember...This is a *perfect world*. If you see in your answer choice where "Call the physician", "Contact a supervisor from another dept", "Refer grieving families to the Chaplin", for example, before you've exhausted everything that you as the RN can do for the patient...Don't pick those answers. If though, you read that everything was done for the patient, I.E. O2 was started, the patient was repositioned, high vent alarms & you've disconnect the patient & started bagging...Then & only then do you contact the physician, supervisor, resp therapist...Etc. You may be asked questions on what to do for a patient based on their abgs or common labs...You'll have to know the normals & what's expected when they're abnormal & know where to go from there. The only other time that you will "Pass the buck" is when an uap or a lpn observed something wrong with another RN's patient. You are not suppose to assess that patient since you don't know that patient's base vitals & situation. Only then would you inform either that RN or contact your supervisor (staying within your chain of command)...Or both. I've seen questions that suggest an uap of 12 years or a lpn of 20 years observes a new grad RN do something that they know (or feel) isn't right. What do you do? Confront said nurse, observed said nurse in their duties, or ask the reporting personnel to elaborate on how they come to feel this way. Unless what the uap/lpn seen is unsafe...Then you as the RN would ask that reporting personnel to explain their concerns further.

Well, I hope this has been some help to ya...Good luck !

UHRN2004 · Nov 20, 2004

Thanks so much for all this information!! I am graduating Dec. 2004 with BSN, and wanted to know the best way to study, and you have answered so many of my questions!! I did want to know though, did you take the Kaplan online course, or did you take the course offered "in-person" lectures?? I know that I want to take the NCLEX sometime in feb. 2005, I want to study and prepare myself well. Any advice on what field of nursing a new grad should look into?? there are many programs in Hawaii, but I don't know if I should start out in med-surg or just go right into the specialty areas. any help would be great.

Nursesuzi · Nov 20, 2004

This is so true. I think of NCLEX like a puzzle. you figure out what the question is asking and then start eliminating. basically, it's less about content than it is critical thinking and problem solving. I passed w/75. my strategy was to review all my binders from school, then take Kaplan, then focus on my weeknesses which were pharm (most people's are). then I took every practice test Kaplan had to offer. not just the disk that comes with the course but I ordered extra tests on line (worth every penny). if you order when you are a member I think its about $100 more. then get good sleep, exercise before you study (o2 to the brain), take vitamins and pray. also, do not wait too long to take the NCLEX. take it no later than one month after you finish Kaplan. the people I know who failed, waited too long (3-6 months after graduation) to take the test. retention. and remember, you will feel like you failed after taking it. but, if you take it w/75 questions and you are not an esl person, you pretty much aced it.

michelleicu · Nov 21, 2004

exactly how many prescription drugs does a nursing student have to memorize all together?

Nursesuzi · Nov 21, 2004

Regarding drugs to know for NCLEX..

It is more important to know all drug categories and their major side effects and special things (like drug action, therapeutic level, interactions, etc.) as well as regognizing major names of drugs and connecting which category they represent.

If you take Kaplan, take the book and it has listings of categories with drugs under that category in the back. I made notes to the side of the page on side effects. KISS (keep it simple, stupid) is the key. Also, I spent 15 minutes each morning with coffee in hand right when I woke up and then 15 minutes right before bed reviewing drugsm (two weeks before my test date). My friend who is an MD. Says that is the most effective way to get it to stick. Also, do the taylored pharm tests that Kaplan offers (if you take Kaplan) and really understand the rationale. Doing as many practice questions as you can will ensure your success, and help you start developing critical thinking skills, that at least MY nursing school did a poor job at helping us develop. And PS. most everything you study/learn for NCLEX will fly out of your head after you leave the test site.

and

michelleicu said:

exactly how many prescription drugs does a nursing student have to memorize all together?

Melanie_C · Nov 22, 2004

gentri said:

I'm taking the Kaplan class. I hope it helps.

Hi there.. I am melanie from philippines and graduating this coming April 2005. I just wanna know what Kaplan is all about.. I don't think so if we also have it here. Thanks. Hope to hear from you.

presC. · Nov 22, 2004

melanie_c said:

what Kaplan is all about.. I don't think so if we also have it here. thanks. hope to hear from you.

hi melanie, Kaplan is a review center that offers comprehensive review for us nurses before taking NCLEX. (actually it offers diff. classes, ex. cgfns, ielts, others) we have different branches here in the philippines. if your place is in makati or in quezon city, Kaplan's available for you. for more inquiries you may call. btw, I enrollled there for my cgfns/ielts and I passed! and once again I enrolled there for NCLEX review. if you have any question or need the phone number you may pm me.

welcome to allnurses also. just browse/surf to different thread and you'll learn a lot!

carvanaragon · Dec 9, 2004

i did not yet see my result for my my NCLEX but here are some tips.

review prioritization. questions like if you are to make a bed for a new admission whom are you going to discharge? what roles may you delegate to a lpn? special diets for special diseases. best time to give a drug. i had a lot of those questions when i took my exam last november 30. goodluck.

Hi,
To everyone who passed recent nclex-rn, can you please share what helped you best (cd's, printed materials, etc..) ? Where to focus? and how did you study/prepare?
thanks... this will help a lot of us who are scheduled to take the exams soon

chris_at_lucas_RN, RN · Dec 10, 2004

I found this tool to be absolutely identical to the NCLEX. It even adjusts the difficulty of subsequent questions based on whether you got the last one right or wrong, just like the NCLEX.

You get a prediction of your probability of passing the NCLEX after each 150 question practice test, plus the rationales for all the possible responses, and whether you marked that one right or wrong.

I had planned to do a test a day until I took the NCLEX. Unfortunately, I was only able to tolerate about six of them in the ten days between when I bought the tool and when I sat for the exam (it's hard work!).

And I sailed through the NCLEX.

For $39.95 plus tax, you just can't get much more support.

I had one problem logging in and the tech support people were great. My "clock" didn't start til I could actually get in there and start answering questions.

Good luck everybody!

Brix · Dec 13, 2004

Hello everyone! I'm also taking my NCLEX exam this year. Thank you for all of your advices and suggestions. To Paula: I know we could make it make. All we have to do is to PRAY and REVIEW.... Goodluck and God bless!

suzanne4, RN · Dec 13, 2004

Review disaster planning and triage....................included on most of the recent exams and most programs do not teach it, the newer programs are just now starting to include it..................

Good luck................... :balloons:

**SKM-NURSIEPOOH, BSN, RN** · Dec 23, 2004

uhrn2004 said:

Thanks so much for all this information!! I am graduating dec. 2004 with BSN, and wanted to know the best way to study, and you have answered so many of my questions!! I did want to know though, did you take the Kaplan online course, or did you take the course offered "in-person" lectures?? I know that I want to take the NCLEX sometime in feb. 2005, I want to study and prepare myself well. any advice on what field of nursing a new grad should look into?? there are many programs in hawaii, but I don't know if I should start out in med-surg or just go right into the specialty areas. any help would be great.

I took the online course only - I'm more of an independent worker. plus I can also work at my own pace & at whatever time I want to.

Hope this helps ~ good luck & :balloons: CONGRATS :balloons: on your accomplishments