Many people ask me to give them tips on the NCLEX so I’ve decided to write this stuff all down from various places. It’s a little disjointed. I bet you all are saying that it is about time…

What helped me the most was answering questions. Lots of questions. Then I studied only the ones I missed. It saved me a lot of study time by directing my attention only to my weak spots and not to studying stuff I already knew.

• Keep in mind that no partical credit is given on the NCLEX.
• You cannot go back to a previous question either. When I took my NCLEX I had conditioned myself to think only about the current question. Block the past and future questions from you mind. At the point you are at, the only one that matters is the one question in front of you. Give yourself tunnel vision during the exam. It will help. I had classmates who agonized over tests and would go back to change an answer multiple times. According to experts on testing, your first guess is usually the correct answer.
• Read the question and ask yourself “what is it asking?” Yes, I know this sounds simple, but most questions I miss I look back and think I thought I was answering a diffrent question. NCLEX question are written so that any of the choices could be correct depending on exactly what the question is asking. First, try to just read the question and answer it without looking at the choices.
• Mark out the wrong answers. My scrap paper on my NCLEX looked like this:
  

  1 2 3 4
  1 2 3 4
  1 2 3 4

  I marked out all the wrong answers and narrowed things down to one or two. (At my school we could mark on test papers. I completed the test on the paper and struck through the wrong choices. If I had difficulty answering a question I marked out the choices I knew were wrong, then circled the question number and went to the next question. At the end of the test when I had time I returned to those questions and devoted more time to answering the question. Only once I had everything answered did I mark my Scantron form.)

• Pick the most correct answer. NCLEX loves to give question in which all the answers are correct, but you have to choose the highest priority or what to do first.
• When in doubt, assess. When you don’t think the question has given you enough information, pick the action that is assessment.
  

  Mary states she has a headache.

  1. ask her to describe her headache
  2. call the doctor for pain medication
  3. teach Mary biofeedback for pain control

  The correct answer is 1. By asking her to describe the headache you may find out more. You may discover that she frequently gets “hungry headaches” or you may need to call the doctor, but you’ll be better armed with information at that point.

• When in doubt, retreat to the ABCs.
  

  Scenario: In the ER, 36 yo male from a motor vehicle accident has just rolled through the door, a right leg amputation with arterial bleeding present. The priority is?

  Correct answer: Airway with C-spine precautions. Controlling bleeding of the stump is not going to help if the patient isn’t breathing because he doesn’t have a patent airway. (BTW, Screaming usually covers Airway & Breathing adequately for a primary survey.)

• Know your priorities and delegate appropriately. Know what your LPNs and CNAs can and cannot do according to thier scope of pratice.
• Keep in mind that you will miss several questions even if you are passing. The way the computer tests is you are given a moderate difficulty question to start with. If you get a question right, it will slightly increase the difficulty of the next question. When you get a question wrong, it will slightly decrease the difficulty of the next question. It will continue in this pattern until the computer determines if you are consistently above or below the competency level.
• Also keep in mind that in a 75 question (minimum) exam, 15 of the questions will be new questions that they are piloting and will not count toward your competency level. But you won’t know which ones these 15 are.