If you are preparing to take the NCLEX, then congratulations on passing nursing school! Only one more obstacle remains between you and your future career as a nurse. So what kinds of questions are on the NCLEX?
Computer adaptive testing
First, you have to understand that in today’s computerized world, the NCLEX has transformed from an old school pencil and paper test to what is called computer adaptive testing or CAT.
This is good because instead of taking the entire test bank, you only have to take as many questions as is necessary for the computer to understand your testing ability.
To achieve this, each question on the NCLEX is assigned a certain difficulty level. The computer will essentially try to get you to point where you are getting one question correct, and getting the next question wrong, and it will wait for you to consistently hover between these two testing difficulties.
When you have reached a certain threshold of certainty, the computer will stop your test (after a minimum 75 questions). If you are above the predetermined passing level when the computer stops your test, then you will pass the NCLEX.
This can be disheartening to people who don’t know how this test works because they will think of it as a standard percentage test and walk away thinking they only got a 50% and failed miserably. But in reality, they could have been testing at the highest difficulty level the entire time, and the computer was simply throwing extremely difficult questions at them every other question in order to get them to get them wrong and stay at a certain testing level.
We have another article that discusses some common NCLEX myths in case you’re interested here: How the NCLEX Really Works.
The majority of the important questions that can make or break you, are prioritization and select all that apply (SATA). What you need to remember is that the majority of these questions are designed to test your critical thinking first, and your knowledge second.
Always ask yourself, what is the safest choice for the patient, because this is always the correct answer.
The people who wrote the NCLEX questions understand that you aren’t an experienced nurse yet. Quite the opposite… you’re brand new! You aren’t expected to know EVERYTHING, but you do need to be deemed safe in order to practice nursing.
When you’re faced with a prioritization question, you need to understand that most if not all of the answer choices are going to be correct responses to the situation at hand. Bummer. So what you need to discern next, is which of these correct choices is the most crucial for the immediate safety of the patient.
Just as an aside on questions/answers regarding the “Call the physician” or “Call the doctor,” you should know that these answer choices are rarely the correct response. Usually, there are other options that you can do prior to calling the doctor, and the only time that this answer response is correct is when there is literally nothing you can do first!
The priority questions are hard, but then you’ve got select all that apply (SATA) questions to deal with. Similar to the priority questions you are often faced with multiple correct answer choices, the catch is, you don’t know how many of them to choose. You could be faced with 5-7 options and technically only 1 answer could be correct.
When I took my test, I remember that most of the SATA questions had about 5 answer choices. I felt like on average most of my SATAs had anywhere from 2-4 answers, and I think that’s a good number to shoot for when taking your test. Rarely were the questions set up where all the answers or just 1 choice was correct.
What to do when you have no clue
We’ve already talked a little bit about what kinds of questions you are likely to encounter on the NCLEX. Pretty much every test in the test bank is going to be some form of prioritization, SATA, math, point-and-label, or fact. But what do you do when you simply do not know the answer to the question?
I am convinced that a person who is simply good at taking tests could possibly pass the NCLEX without going to nursing school and studying much, so long as they understand a few key concepts. The NCLEX is not so much designed to test your knowledge of facts, but rather, your way of thinking. This is good because as long as you know this, you should be able to pass, even if your grades aren’t that great.
The fewest questions in the bank are the ones that this good hypothetical test taker would fail. Fact-based questions that you don’t automatically know the answer to are a pure guessing game if you cannot narrow down between any of the options.
Fortunately, I’m assuming that you’ve attended nursing school for 2-3 years so you should be able to narrow it down to at least 3, but hopefully just 2 lonely options. At this point, you have a 50/50 shot, and I would go with whatever answer “feels right,” because I’m guessing that that small bit of intuition has some logic to it back in the dusty long-term memory recesses of your brain.
And if you aren’t a math wiz, fret not. These questions are few and far between on the NCLEX and they are not weighted very heavily (so they won’t fail you alone). During my test, I only received 1 math question.
Do yourself a favor and don’t psych yourself out if you get these little fact-based questions wrong. They won’t make or break you, I promise!