Nursing candidates preparing for the NCLEX exam often wonder how to answer NCLEX questions. Unlike tests taken in nursing school that primarily measure knowledge, the NCLEX exam, assesses a candidate's ability to analyze and apply nursing knowledge to real-world healthcare scenarios. The NCLEX is built upon Bloom's taxonomy, a learning model that categorizes domains of knowledge into six levels of understanding from low-order thinking to higher-order thinking, starting with the basics. Often this model is viewed as a bottom-up pyramid of learning and shows how learners acquire and understand information throughout the cognitive process, starting with the ability to remember and recall knowledge:
Understanding more about Bloom's framework of learning will help NCLEX candidates move beyond rote memorization and into the domains of knowledge that are measured in the exam that require one to process thoughts. Most question types on the NCLEX are written to assess knowledge at the Apply, Analyze, and Evaluate levels of Bloom's pyramid.
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Create AccountKnowing the parts of a typical NCLEX question can also help candidates understand how to answer these NCLEX questions. Multiple-choice questions, for example, are easier to answer when the test-taker understands the structure of the question. These questions will present a scenario of information and a prompt, such as '' which of the following''" or ''"what is the most appropriate,''" and this is known as the stem of the question. Four options follow the stem, but only one of the options is the correct answer; the other options are called distractors. At times, it can feel like a few of the options could be correct so it is important to look for keywords as clues to identifying the correct response. Clues in the stem such as ''"most,''" ''"best,''" and ''"except''" can help the candidate narrow down the options and discard the distractors. Identifying these essential components of NCLEX exam questions can lead test-takers to understand and interpret patterns in the test structure.
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Create AccountIn addition to multiple-choice questions, which make up 80-90% of the NCLEX exam items, there are several alternate test item formats, including multiple-response, hot-spot, fill-in-the-blank, chart or exhibit, drag and drop, graphic option, and audio and/or video questions. Understanding the various formats will help candidates know how to answer NCLEX questions on exam day. The information below provides an overview of the alternate formats and what candidates can expect from these types of questions.
Multiple-response, or select all that apply (SATA), questions are like multiple choice, but instead of four options with only one correct answer, NCLEX SATA questions will have more than four options and multiple correct answers. Even one missed correct choice selection will result in the whole answer being incorrect, so candidates will want to think about all the possibilities. After choosing the assumed correct responses, review all options to be sure the ones not chosen are indeed incorrect. It is helpful to approach NCLEX SATA items as true/false questions broken down into multiple parts. For each option, decide whether it is a true option or a false option, and that will help choose all correct, or true, answers.
Hot-spot questions require candidates to pick out a certain location (a site for injection or an assessment area on the body). These questions often begin with the words '' identify' ' or ''select' ' and feature an image on which the candidate will need to locate the answer. These questions are answered by clicking on the correct location, which inserts a red X onto the graphic.
Fill-in-the-blank questions typically cover calculations related to healthcare scenarios, such as the amount of medication or a conversion between measuring units like kilograms to pounds. In this question format, the question stem will guide the test-taker by including information on the unit of measure and if the candidate should round the answer up or down. Calculators and scrap paper can be used to complete the math equation, and the numerical answer will be typed into the computer.
Chart questions include a mock patient's chart, including all the typical data a nurse would expect to view. The stem will expect the candidate to respond to questions based on an analysis of the chart data. Successful responses will only use the data provided, so it is important to review the chart data thoroughly.
In drag-and-drop questions, candidates will view up to six items that they are asked to move into the correct order. For example, a drag-and-drop question might ask a candidate to place the steps of inserting a patient IV into the correct order of events. It is helpful to imagine oneself in an actual patient care situation and visually review the steps as if they were happening. This technique can help to ensure the steps are put in the correct order. Like in multiple-response questions, if even one item is out of place, the whole question will be considered incorrect, so be sure to briefly review the ordered list before proceeding.
Just as in multiple-choice questions, graphic option questions ask candidates to identify a correct response, but instead of worded options, the options are images or diagrams. A graphic option item may ask the candidate to choose the picture that most closely shows a particular diagnosis. For example, the candidate may encounter a question of this type that includes four images of lungs, from which they must choose the image that is most consistent with a diagnosis of pneumonia.
In audio or video items, candidates will click a play button to listen or view a clip and answer a question about it using an analysis of their knowledge and application to the scenario presented. These questions are typically centered on clinical situations and the clips can be replayed as needed.
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While taking the NCLEX exam, candidates should also be aware of priority questions, which require a prioritization of patient needs in order to choose the best response. Priority questions can be identified by scanning for keywords and phrases such as '' best,' ' '' first,' ' ''immediate,' ' ''primary,' ' and ''essential,' ' which are all indicators of priority questions on the NCLEX. Test-takers can use common rhetorical frameworks for assigning prioritization to all of the available options, such as by using the nursing A.B.C. (airway, breathing, circulation) and the expanded ABCsDEF (add safety, discomfort, education, feelings). The expectation is that from among all the available options, candidates can use these frameworks to narrow down the most appropriate response from the many potentially correct responses. It is important to remember that correct answers should never ignore the patient's immediate physiological needs, and that delegation is not the proper answer in these contexts.
Common strategies can help candidates successfully pass the NCLEX exam. One such strategy is to be wary of absolute statements in answer options. These absolutes tend to make the option incorrect and words such as '' all,' ' '' always,' ' '' ever,' ' and '' only' ' can help identify an absolute option that can safely be excluded as the correct option.
Another strategy is to focus on options that respond to the client. For example, NCLEX test-takers should never choose an answer that requires leaving the patient, delegating treatment, or deferring responsibility to another staff member. This strategy also includes avoiding options that assume more information than is available. In general, the candidates are urged not to read more into the question than necessary, to only use language that is included in the wording of the question itself, and never assume hidden intent within a question. It is also important to assume ideal hospital resources are available in any response and to stay focused on the patient's needs first by assessing before acting. In general, the way NCLEX questions are written is designed to confuse the test-taker, so use these strategies to better understand how the analysis of question wording will help to identify correct answers.
In 2023, the NCLEX exam format was updated. This new, current exam is commonly referred to as the Next Generation NCLEX (NGN). The NGN offers questions to help nursing candidates apply critical thinking in a deeper way and will ensure successful candidates are prepared to help patients reach the best health outcomes.
The NGN format of the NCLEX features five new question categories: Extended Multiple Response, Extended Drag and Drop, Enhanced Hot Spot, Cloze, and Matrix. Extended multiple-response questions are still featured, but on the NGN, there are more options and partial credit awarded. Similarly, the Next Gen has extended drag-and-drop items that include more options than correct answer spaces. Enhanced Hot Spot questions can be answered by clicking pre-defined words or phrases to highlight them. These items enable the candidate to review a mock patient's medical record and select the words or phrases that answer the question stem.
Two of the categories are different from the pre-2023 question formats. One is Cloze, or drop-down items. Within the question, the candidate will find one or more drop-down menus from which to choose the word or phrase that best answers the question(s). Cloze items might feature drop-down options as part of completing a statement, a chart, or a table. The second new category is the matrix, or grid, item type. The candidate will answer these questions by selecting the correct answer(s) within each row or column from a grid. For example, in a table with five rows, the candidate would need to select one of three options for the correct answer in each row to complete the item.
Kariz Zozaya, R.N. has over 8 years of experience in nursing. She has worked in a cardiovascular unit, in a neonatal I.C.U., and as a Concurrent Review Nurse. In the pursuit of her certification, Kariz passed the NCLEX and HESI exams. She earned her A.D.N. from the University of Texas at Brownsville.
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The 2021 NCLEX contains between seventy-five and one hundred-forty-five questions, 15 of which are pre-test questions that are not scored.
Priority questions are considered challenging on the NCLEX. These questions require a candidate to apply knowledge while analyzing and evaluating a complex scenario to put the steps in the process in order according to how a nurse would best serve a patient or complete a procedure.
The primary topics on the NCLEX include the following with the percentage of the test the respective topic covers:
The number of correct questions to pass the NCLEX will vary. The NCLEX is a Computerized Adaptive Test (CAT), in which the computer calculates the candidate's ability by calculating the difficulty of prior answers. The exam then chooses the next question that has about a 50% chance of the candidate responding correctly. Each answered question improves the computer's understanding of how to accurately measure knowledge. For this reason, each candidate will answer a different number of questions based on the computer's adaption.