What do I HAVE to know to pass NCLEX?

I taught in the Kaplan NCLEX review course for years. Whatever resource you use to study, make sure it gives you the rationales for why the wrong choices are wrong as well as the right ones, right. This is where most people fall down-- they pick an answer that is factually true but is not the best answer for the situation as it would be assessed by a good RN. They try to memorize facts but forget critical thinking skills that are, well, critical in all nursing judgment. Nurses Announcements Archive HowTo

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NCLEX items are developed in part from knowing what errors new grads make and how. They tend to be of two kinds: inadequate information, and lack of knowledge (these are not the same thing). The goal of NCLEX is to pass candidates who will be acceptably SAFE in practice as NURSES. So-- they want to know what the prudent NURSE will do.

How To Pass NCLEX

STEP 1 When confronted with 4 answers, you can usually discard 2 out of hand. Of the remaining two...

  • Always choose the answer that (in priority order) makes the patient safer or gets you more information. "Can you tell me more about that?" "What do you know about your medication?" "What was the patient's lab result?"
  • NEVER choose the answer that has you turf the situation to another discipline-- chaplain, dietary, MD, social work, etc. It's often tempting, but they want to know about what the NURSE would do. See "always..." above.

STEP 2 "Safer" might mean airway, breathing, circulation; it might mean pull the bed out of the room and away from the fire; it might mean pressure ulcer prevention; or improving nutrition; or teaching about loose scatter rugs ... Keep your mind open.

It might also mean "Headed down a better pathway to health." For example, while telling a battered woman who has chosen not to leave her partner that "studies show that he will do it again" is factually true (and that's why this wrong answer is often chosen), the better answer is to acknowledge that you hear her choice to stay and say "now let's think of a plan to keep you safe." This doesn't turn her off from listening to you, so she will trust you, acknowledges her right to choose, and helps her along a path to better safety.

STEP 3 Read carefully.

If they ask you for a nursing intervention answer, they aren't asking for an associated task or action which requires a physician plan of care. So in a scenario involving a medication, the answer would NOT be to hang the IV, regulate it, or chart it; it would not be to observe for complications. It WOULD be to assess pt knowledge of the med/tx plan and derive an appropriate patient teaching plan. Only that last one is nursing-independent and a nursing intervention.

Exam PreparednessAgain, they want NURSING here.

STEP 4 The day before the test, do not study.

Research shows that your brain does not retain crap you stuff into it at the last minute-- musicians learning a new piece play the first part on Monday, the second part on Tuesday, and the third part on Weds. Then they do something else entirely on Thursday; meanwhile, behind the scenes, the brain is organizing the new info into familiar cubbyholes already stuffed with music, putting it ready for easy access. On Friday, the whole piece works much better.

What this translates for in test-taking land is this: The day before the test, you go to a museum or a concert, go take a hike, read a trashy novel, make a ragout, do something else entirely. Take a small glass of wine, soak in a nice hot bath in a darkened tub with a few candles on the sink, get a nice night's sleep.

STEP 5 On your way out the door in the morning, open the refrigerator door and read the mayonnaise jar label. Do what it says: Keep cool, do not freeze.

Then go to the testing center, you incipient RN, you!

Specializes in Med-Surg, NICU.

This is a wonderful article! I will (most likely) be taking the NCLEX in January, but I am super nervous about failing!

Thanks!

Thank you GrnTea! I'm thinking of printing this out & hanging it somewhere that I can see it everyday.

Got 2 weeks before attempt number three...making myself study at this point...just cannot bear failing one more test. I have done all I know to do to prepare the best I can. I'm praying a lot every day, asking for prayers from anyone who will and trying to stay positive and believe in myself and my ability to pass and begin my dream of being a RN. let us have have faith in each other, pray for each other and believe in each other this time..and succeed!

This reminds me of a cautionary tale:

The rain was coming down and the radio announced that people should evacuate the low-lying lands around the river. His neighbor came by in her truck and offered him a ride. "No," he said. "God will provide." And she left.

The water rose to the front porch. The police came by in a small boat and told him to get in. "No," he said. "God will provide." And they left.

The water rose to the roof, and a helicopter flew overhead to get him in the basket. "No," he said. "God will provide." And they left.

And the water rose, and he drowned.

When he got to heaven, he was offered one chance to ask any question he wanted, so he said, "Lord, I believed in you to save me! Why did you let me drown?"

And the Lord said, "I sent the radio, your neighbor, the police, and the helicopter. What more did you want?"

Moral of the story: Less praying, more studying. I've always felt prayer is better used for thanks than for begging, anyway.

Subscribed... any other educators, moderators, etc... chime in. I just graduated and starting to study today. Thanks.

All, I just got the nicest note from someone who had already failed NCLEX twice and was despondent. She studied and studied, memorized lists of normal values and drugs, and did bazillions of practice questions, and still failed. She asked what she could possible do different..and I answered her that she needed to stop focusing on memorization and start focusing on meanings, rationales, understanding the WHY of every fact she knew.

NCLEX (and nursing) expects you'll have some level of baseline fact knowledge, of course, but is much more concerned that you know how to think about using them when you have them.

Do you need to get more information? Why?

Do you understand what's important in a scenario or question, and what's not? Why?

Do you know what's expected? Why?

Do you know the effect of a drug? Why do we care?

Do you know what a lab value means? Why do we care?

So many more whys...

Why, why, why... it's the basis of everything we do, it's the foundation of critical thinking in three little letters. It's not something you have to do just to pass NCLEX, it's something every nurse has to do every day of a professional life.

Anyway, that's what I told her. And today I got an email telling me that she stopped memorizing and started thinking about her critical thinking, and found herself on 12/29 going into the testing center calm and confident. And like the mayonnaise: cool but not frozen. And she passed.

Is it really important to use the most up to date, recent NCLEX book while studying for the actual NCLEX or can we do fine by using slightly older books?