Mastering The NCLEX The First Time: Strategy And Tips

The NCLEX-RN protects the public by testing whether you actually know how to care for patients. The questions imitate real clinical situations, so they reward judgment, not memorization. It's a big exam, but it's beatable with the right preparation. Here's how the test works and how to approach the questions.

Recent Changes to the NCLEX

In April 2023, the NCSBN launched the Next Generation NCLEX (NGN), built to reflect the complex clinical situations modern nurses face. The questions simulate hospital settings and test the skills you use on the floor: critical thinking, judgment, decision-making, and clinical skills.

The NGN added new formats to handle that complexity, including extended multiple-response, extended drag-and-drop, and grid-based items. The scoring model changed too. The old model scored answers right or wrong; the new one allows partial credit.

How Learning Styles Help in NCLEX Test-Taking

Anne Dabrow Woods, chief nurse at Wolters Kluwer Health Learning, Research and Practice, tells candidates to know their learning style and stick with what has worked before, whether that's auditory, kinesthetic, visual, or a mix.

"Some tried and true methods are using mnemonics, drawing out concepts or relationships, using the teach-back method where you teach someone else about concepts and applications, or using flashcards," Dabrow Woods says. "As adult learners, we retain more information if we use a variety of study methods to learn information."

NCLEX Test-Taking Strategies

Break a multiple-choice question into its parts before you answer it:

• The stem asks the question.
• The case is the patient's situation or scenario.
• Distractors are the wrong or weaker choices.

Read the stem at least twice before you commit. The strategies below tighten that up.

Identify Keywords

Focus on what the question is actually asking for. "If the question asks for an intervention, look for the answer that is an intervention," Dabrow Woods says. Choices that list signs and symptoms instead of an intervention get eliminated.

Identify Repeated Words

Watch for repeated words and synonyms across the question and answers. If a question contains "signs," the right answer may include "symptoms."

"Test-takers have a tendency to read too much into answer choices and overanalyze," says Alaina Ross, RN and expert contributor for Test Prep Insight. "Do not fall into this trap."

Do Not Second Guess Yourself

Don't reread meaning into the question and don't change answers. "The first answer is usually the correct one if you have taken the time to reason through the question," Dabrow Woods says. Ross adds: "Read each answer choice and pick the best choice based on instinct."

Look for Opposite Answers

When two choices are opposites, like increased heart rate versus decreased heart rate, one of them is usually correct. Knowing every question type you might see makes this easier to spot, Ross says.

Read the Entire Question Before Answering

"Read the entire question before focusing on the answer," Dabrow Woods says. Skim it and you'll miss a keyword or misread the focus. Make sure you understand what's really being asked, on practice tests and the real thing.

Eliminate Distractors

Cut the wrong choices first, then weigh what's left. "If the question asks for an intervention but some of the distractors are signs and symptoms, eliminate those distractors and focus on the one that most closely resembles the right answer," Dabrow Woods says.

Use Prioritization Techniques

Words like initial, first, and best are asking you to prioritize. The choices are often all correct, but only one comes first. Use these frameworks:

• ABCs (Airway, Breathing, Circulation): Airway problems and airway interventions get top priority.
• Maslow's Hierarchy of Needs: Physiologic needs (pain, food, sleep) come before safety, security, and psychosocial problems. Useful for complex patients with multiple problems.
• Nursing Process: Assess before you plan or intervene. Ask whether you need more assessment data before acting or calling the provider.

NCLEX Scenarios

In NCLEX scenarios, you're the only nurse with a single patient and every order you need. You can call the provider, but realistically you only do that after an intervention has failed and there's nothing else within your scope.

Real shifts are messier, but the exam isn't hard for its own sake. These stripped-down scenarios test your grasp of fundamentals and critical thinking so you're ready for the complicated version on the floor.