nurseresident-blog

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How to prepare for the dreaded NCLEX...

In nursing school, you are preparing to become a nurse.  You are learning how to become a critical thinker, you are learning how to perform both basic and complex skills, you are learning how to care for the sickest of patients.  However, you are also preparing for the NCLEX at the same time, because that is what you need to take in order to become a Registered Nurse.  So I made a list of questions that I had when I was preparing for the NCLEX.  If you have any other questions, please feel free to ask and I will try my best to answer them! 

1. What is the NCLEX? 

The NCLEX exam, also known as the National Council Licensure Examination, is a standardized exam that each State Board of Nursing uses to determine whether or not a candidate is prepared and safe enough to practice nursing at an entry-level. Before you are able to sit for the NCLEX, your first step is to successfully complete an accredited nursing degree (either Associate’s or Bachelor’s). 

2. How do you sign up for the NCLEX? What is the process? 

This varies by state so I can only give you the overall process. Most schools will walk you through the process as well, which is nice.  Before you graduate, you can apply to your State Board of Nursing and complete any requirements such as fingerprints, a background check, or any other paperwork before graduation.  I would suggest you apply and complete your requirements as soon as you can because sometimes the State Board of Nursing can get backed up when a large influx of applications come in. Once you graduate from an accredited nursing school, the College of Nursing will send your completed degrees to the registrar office to be awarded.  Once your degrees are awarded, the College of Nursing will send your awarded degrees to the State Board of Nursing.  From then, the State Board of Nursing will receive everything and determine if you are qualified to sit for the exam.  Once the State Board of Nursing determines you are qualified, they will send you your Authorization To Test (also known as ATT).  Your ATT will let you schedule yourself to take the NCLEX.  You are able to take the NCLEX at any Pearson Testing Center.  For instance, if you applied to be registered in the state Florida, you can travel to Georiga to take the exam even though you will be registered in Florida.  I personally applied to be registered in Pennslyvania, but I took the exam in Florida.   

3. How many questions are there? 

The minimum amount of questions you can have is 75.  The maximum amount of questions you can have is 265.  However, you can have any amount of questions in between that.  My computer didn’t shut off until question 95.  The NCLEX is a computer adaptive test, so that means it will keep going until it feels that you have passed or failed.  There is a standard that you must be above to pass (the line is used to measure minimum competency allowed for you to safely practice).  If you are clearly above the passing standard at this time, you will pass; likewise, if you are clearly below the standard you will fail. If you are too close to the standard to allow a definitive result to be determined, you will continue to answer questions until a final assessment can be made.

4. What are the types of questions on the NCLEX?

In the past, all NCLEX questions were multiple choice. Although many are still of the multiple-choice type, a lot of questions are now in a different format. However, a good amount of the questions continue to be multiple choice. Questions come in three levels. Level 1 is general knowledge and generally delivered as multiple choice. Level 2 is on analysis and application, which may or may not be multiple choice. Level 3 questions are the hardest of all and require you to apply facts, processes, and rules in order to answer them. Often, these questions are open questions. Around 90% of the exam is made up of level 2 and 3 questions.

The types of questions you could possibly have on the NCLEX are: 

Multiple Choice 

Select All That Apply: Think “true or false”

The select-all type questions are pretty self-explanatory: They include more than one answer in the same question, usually with five possible options. When you read through them, it’s best to consider each answer as either true and false, with the true options being the correct answers. Here’s the tricky thing: With these types of questions, you get all or no points. No partial credit is given if you choose only some of the correct answers. That may seem daunting and even frustrating, so remember to take your time. Make sure to review several select-all questions as you study, so you’re familiar with and prepared for the format. Many students find these to be the most difficult questions, which means it can get easier from here.

Ordered Response: Order everything

Ordered response questions are those that require you to place the answer options in the correct order using the drag and drop method with the computer mouse. There’s nothing wrong here, but there is only one right order from start to finish. Whatever the scenario of the question, you’ll use all of the options and rank them in the correct order as directed.

Fill-in-the-Blank: Study up on your calculations

Fill-in-the-blank formats may seem intimidating, because you won’t have any answer in front of you, but with the right studying you’ll know exactly how to find it. These questions are often used for calculations of medication dosage, IV drip rates, intake and output, and due dates for pregnant women (using the first day of their last menstrual period as a guide). As long as you study and know how to do these and similar calculations, you’ll be fine.

Hot Spots: Pay attention to specific areas

Hot spot questions are often used with pictures of a body part. You’ll be asked to use the mouse to click on the specific area indicated in the question’s scenario. For instance, you may be asked the best place to auscultate the apical heart rate. You would then click on the correct place on the picture of the chest.

Exhibits/Chart: Remember how to interpret (and use) bedside charts

Exhibits/Chart questions include tabs that, when clicked on with the mouse, will give you more information about the client, similar to a bedside chart. There may be several tabs to open to reveal the information needed to answer the question. You’ll use this information to guide you toward the correct answer.

Graphic: Think in pictures, not words

Graphic questions use graphics (e.g., pictures, diagrams, heart rhythm tracings) instead of words as answer options. For instance, you may be asked to identify the heart rhythm that requires the most rapid action by the nurse, and would then choose from four different illustrations of rhythms. Or, you may be told that your laboring client is having back pain so you would need to choose a picture of the best position to relieve this client’s pain.

Audio: Listen close for answer clues

Audio questions will require the use of headphones to listen to an audio clip of information. This may include heart sounds, lung sounds, or client speech patterns. You’ll then be asked to interpret what you hear or make a decision for care based on what you hear. Take your time, and listen closely. You’re allowed to replay the audio if needed.

5. What are the topics on the NCLEX? 

The content of the NCLEX-RN is organized into four major Client Needs categories. Two of the four categories are divided into subcategories: 

Safe and Effective Care Environment

Management of Care

Safety and Infection Control 

Health Promotion and Maintenance

Psychosocial Integrity

Physiological Integrity

Basic Care and Comfort

Pharmacological and Parenteral Therapies „ 

Reduction of Risk Potential

Physiological Adaptation

All of the questions asked on the NCLEX will be related to these topics. 

5. How many practice questions should I take? 

Personally, I answered about 2,500 practice questions.  However, everyone studies differently.  Some people I know practiced way less and some people I know practiced way more than I did.  It is recommended that you practice as many questions as you can in order for you to feel comfortable.  

6. What are the best study materials? 

Here is a list of the best NCLEX study materials: 

Saunder’s Comprehensive Review for NCLEX-RN Examination

Organized in 20 units and 77 chapters, the book offers detailed reviews of all of the nursing content areas that are relevant for the NCLEX-RN. Equally important is the guide’s provision of practice questions: Each chapter includes targeted multiple choice and alternate item review questions and there is a comprehensive test covering all subject areas in the book’s final unit. Every question is accompanied by detailed answers and explanations. Furthermore, as part of these explanations, the book also provides helpful test-taking tips and strategies on how to tackle the various types of questions

Saunder’s Q & A for the NCLEX-RN Examination

Now offering more than 6,000 test questions, the guide provides an excellent source for garnering practice with NCLEX-RN type questions.  Practice, after all, is often the difference between a passing and a failing score, and this book makes sure that you will get that much-needed practice.

Kaplan’s NCLEX-RN Premier 2017

The book offers a full-length NCLEX practice test as well as an answer key and detailed explanations for all the answers.  In addition, it offers access to a second NCLEX practice test online.  Exam-style questions broken down by each of the sections of the NCLEX-RN test, DVD video tutorials, and mobile study resources are also provided.  Further bonuses include a guide on becoming licensed, tips for taking the test after previously failing it, and a guide for international nurses.

Prioritization, Delegation, and Assignment: Practice Exercises for NCLEX

To this end, the guide provides focused content review, case studies, and challenging practice questions – complete with detailed answers – that mirror the various types of questions that you may encounter on the actual exam. Especially noteworthy is this book’s effective threefold organization, which progresses from foundational skills review to application of those skills, to extension of complex patient/health scenarios.

UWorld

UWorld’s NCLEX prep includes over 1900 challenging questions, 30% select-all-that-apply (SATA) and alternate items, Includes two (2) 75-question self-assessments with NCLEX readiness predictor, detailed rationales for correct and incorrect options, and multiple concepts per question to reduce preparation time.  

7. One last piece of advice... 

When studying, I often became overwhelmed, just thinking of how much information there was and how much I could realistically cover. It is then, during moments of panic, that you should take a step back, have a snack, breathe in some fresh air, and take your mind off nursing for a brief period. Go take a walk, go out to eat with some friends, go do something fun.  Go do anything to get your mind off studying, even if it’s just for 30 minutes.  Anytime you catch your mind wandering or having to constantly re-read you should take a break because you aren't retaining anything at this time. 

Remain positive and confident during the whole process.  Realizing that you are so much smarter than you think will help to build your test-taking confidence tremendously.  Try not to psych yourself out, because it will only lead to downfall.  

Spend the day before, and the morning of, doing something for your mental health. Relax and try your best to keep any thoughts of NCLEX out of your head, at this point you know everything you need to in order to pass, you just have to be mentally prepared. For myself, I used copious amounts of lavender oil to help reduce my anxiety and to help me sleep well the night before. I also took a bottle of lavender oil to the testing facility, which I never needed because I wasn’t there long enough to need a break, but it was a nice comforter. 

Lastly, go into the testing center with a smile on your face, tell yourself that you ARE smart enough, and you WILL pass the NCLEX. 

If you would like more information about the NCLEX-RN, visit https://www.ncsbn.org/nclex-faqs.htm for more information! 

“Doubt kills more dreams than failure ever will.”

[nurseresident-blog]

So, like I said in my previous post... Once I graduated, I felt empty.  I was used to having something planned every minute of every day.  It is OKAY to feel empty.  Do not jump into studying for the NCLEX right away.  Take time for yourself.  Take time to recharge.  You have worked so hard for this, so you deserve a break. 

[nurseresident-blog]

So I graduated... Now what?

Hi there, everyone! For my first post, I wanted to introduce myself and explain why I wanted to create this blog in the first place...  

My name is Amanda Schultz, and I graduated from the University of Central Florida with my Bachelor’s of Science in Nursing on May 5, 2017.  The 4 years that I spent at the University of Central Florida were truly amazing.  I kept myself busy and tried to get as involved as I possibly could.  From joining multiple honor societies to taking on leadership roles, I was able to gain so much knowledge and experience.    

After graduation, I felt like I was missing something.  I was in school for 4 straight years.  Then just like that, I had nothing to do.  I was used to being so busy all the time, I actually forgot what it felt like to breathe and relax for once.  

Nonetheless, about a week after graduation I had many things that needed to get done.  I had to find a nurse resident job.  I had to study for the NCLEX.  I had to get everything together to move back up north to New Jersey.  So, I was busy once again. 

On May 7, 2017, I sat down and started my job hunt. I have always wanted to work at the Children’s Hospital of Philadelphia.  In fact, it has always been my dream to work there.  I took a leap of faith and went onto their career page and saw that they had a Critical Care Nurse Resident (Entry-Level) Position open.  I was in disbelief!  I read the description and saw that those who were selected would rotate/float between the Neonatal ICU, Pediatric ICU, Cardiac ICU, Progressive Care Unit, and Cardiac Care Unit.  My. Dream. Job.  I was almost in tears.  I sat down and gathered everything that I needed and applied.  I had no idea what the application or interview process would be like, but that didn’t matter. Once I applied, that was it.  It was time to focus on studying for the NCLEX. 

I started studying for the NCLEX on May 15, 2017.  I did self-studying, I took the in-class Kaplan course, I did everything that I needed to do to prepare for this *intimidating* test. I completed over 2,500 practice questions, and I studied content as if I didn’t even learn it back in nursing school.  *I will make a separate FAQ post on how to prepare for the NCLEX.*  On June 28, 2017, I took the NCLEX.  I had 95 questions, and it took me almost 2 1/2 hours to complete.  When I was walking out of the testing center, I kept thinking that I failed.  However, the next morning I checked my Pennsylvania Board of Nursing portal and saw that my results were posted!  I PASSED THE NCLEX AND BECAME A REGISTERED NURSE! 

So, let me get back to the main point of this post... I decided to create this blog to help graduate nurses understand what their first year might be like.  Everyone’s journey might be a little different or not even close to what my journey is like.  However, that is what makes the nursing profession so amazing.  I absolutely love helping others (which is why I came into this profession), so if you have any questions or want me to write about something specific please don’t hesitate to reach out! 

“Difficult roads often lead to beautiful destinations”