Graduating from nursing school is not the end of test taking for nursing students. The NCLEX exam is like the ultimate final exams because in here they do not study for grades but they study for being a professional nurse. Passing the NCLEX is a graduate nurse’s first step to jumpstarting their career in the field of nursing.
Apart from studying all the concepts, principles and theories in nursing, graduate nurses should have a strategic approach in answering NCLEX type questions. What every graduate nurse should understand is that the NCLEX exam questions will not measure how much they have learned in nursing school but will assess their competence and readiness to care for actual patients. To pass the NCLEX, a very important skill to develop is critical thinking.
Breaking down the NCLEX questions
A question consists of the stem (part that asks the question), the case (patient’s condition or the scenario), the answer, and distractors (choices that look correct but are actually wrong). It is easier to analyze once you have identified the different parts of the question.
1. Look for keywords
No matter how a long a question is, there is that one word or phrase that bears the most weight. Key words may relate to the client, the actual problem, and to specific aspects of the problem.
2. Repeated words
The same words may appear in the NCLEX question and in the correct answer. It may be the same word or a synonym of the word.
3. Opposite answers
If two choices have opposites, like increased heart rate or decreased heart rate, one of the two choices is usually the correct answer.
4. The Odd answer
The one answer that is different from the rest is apt to be the correct answer.
5. Umbrella principle
If all answers seem to be correct and applicable, choose the one that includes all the choices in it. One answer is better than all the others because it includes them.
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6. Eliminate obvious answers
In NCLEX questions asking for a single answer, some choices are obvious to be incorrect. You should be able to identify some of these incorrect responses if they are/have:
the same idea– eliminate choices that have the same concept or idea. these choices are just reworded but if you analyze them carefully, they are actually one and the same
absolute answers– choices containing the words all, never, always and the like are very likely to be incorrect.
unrelated to the question– if the question asks for interventions and the action in the choice is an assessment, it is obviously incorrect.
After eliminating the obvious incorrect answers, analyze the remaining choices and select the option that best answers the stem.
7. Prioritize based on patient’s needs
Questions containing the words initial, first, priority- is asking for your prioritizing skills. The choices are usually all correct but only one should be done first. When prioritizing, you should always remember the following:
- ABC’s– use ABC’s (airway, breathing and circulation). Patients with airway problems or interventions to provide airway management are top priority.
- Maslow’s hierarchy of needs– remember the hierarchy and from there you will know that physiologic needs come first before safety and security and so on and so forth. This is typically used in patients with multiple problems to be addressed.
- Nursing process– Assessment should always be done before planning anything or instituting interventions. Unless the question already has subjective and objective data about the patient, assessment is at the top of the list
- Patient first before equipment– if a patient is attached to an equipment and sudden removal of the equipment causes problems, primary assessment and interventions should be directed to the patient and not to the equipment.
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