Chapter 05: NCLEX-RN® Examination and the New Graduate

The nurse interprets "computer adaptive testing (CAT)" to mean a. questions are selected, and the exam is adapted to the candidate's previous responses. b. the test has been "adapted" to be administered via the computer. c. the test is adapted to decrease the total number of questions. d. questions are adapted to meet the practice analysis survey of the graduates.

ANS: A Questions are selected for each candidate based on the test plan. When a candidate misses a question, the computer will present an easier question from that same category. Computer adaptive testing (CAT) does not mean that the computer has been adapted for administration via the computer. The test is not adapted to decrease the total number of questions. The number of questions each candidate receives and the testing time for each candidate will vary. As candidates answer questions correctly, the next question will be either a degree of difficulty equal to the previous question or a higher level of difficulty The practice analysis survey is the research basis for constructing the test plan. The test has a minimum of 75 questions and maximum number of 265 questions; it does not "decrease the total number of questions."

Which statement indicates the graduate nurses understanding of the process at the NCLEX® testing site? a. "I will be thumbprinted and photographed." b. "I will be placed in a locked testing cubicle." c. "I will answer 300 test questions." d. "I will be given some questions as a paper-and-pencil test."

ANS: A Read the Candidate Bulletin and the instruction packet carefully. An Authorization to Test (ATT) will be required for admission into the testing center; however, after January 1, 2014, the NCLEX will be going paperless, so the ATT will not have to be brought to the testing center. All candidates will be thumbprinted and photographed and will have a palm vein reader as part of the identification process at the testing location. Candidates are not locked in a testing cubicle or given a paper-and-pencil test. The number of questions on each candidates test may vary with a minimum of 75 questions and a maximum of 265 questions

The nurse interprets the role of the individual state boards of nursing in the NCLEX® Exam as which of the following? a. To coordinate with the National Council State Boards of Nursing in administering the examination and licensing candidates to practice in respective states b. To prepare a licensure examination that is reflective of entry-level practice in their respective states c. To grade the examination, advise students of the results, and transmit all results to the National Council State Boards of Nursing for their files d. To supervise and administer the examination to the candidates within their state jurisdictions

ANS: A Representatives from the state boards of nursing are members of the National Council State Boards of Nursing (NCSBN). The state boards of nursing determine the requirements to take the NCLEX® Exam in their state and serves on national committees to prepare the examination. These representatives do not grade the examination, advise students of results, or administer the examination. Pearson VUE administers the exam for the NCSBN

The graduate nurse understands the process of NCLEX-RN® Exam scoring and reporting when stating: a. "The NCLEX-RN® Exam is scored on a pass/fail basis and is reported directly to the candidate." b. "The candidate must score 80% or higher to be considered competent; scores are reported to the school." c. "If the candidate must answer more than 365 questions, he or she will not pass the examination; scores are reported to the board of nursing." d. "Scoring is based on the level of difficulty of the questions presented to the candidate; scores are reported to the candidate."

ANS: A The NCLEX-RN® Examination is scored on a pass/fail basis (competent/non-competent), and the scores are reported directly to the candidate. There is no percentage assigned to the passing score, and a candidate cannot take more than 265 questions. The level of difficulty is a component of the scoring process

Which of the following statements indicate the nurses understanding of the content of the NCLEX® Exam? a. "The exam is based on a practice analysis conducted by the National Council of State Boards of Nursing." b. "The exam is a survey of nursing faculty regarding areas of importance for testing." c. "The exam includes questions based on the National League of Nursing survey reports." d. "The exam includes contributions from all of the member boards of the National Council."

ANS: A The National Council of State Boards of Nursing conducts a practice analysis to determine what is being required of new graduates in their place of employment. The test plan for the NCLEX® is based on this research. The test plan is not based on a survey of nursing faculty, survey reports from the National League of Nursing, or contributions from member boards of the National Council State Boards of Nursing.

To adequately prepare for the NCLEX-RN® examination, which action by the graduate nurse is advised? a. Begin planning early at least 6 months ahead. b. Begin planning no more than 3 months ahead. c. Wait for the state board of nursing to contact the applicant about filing deadlines. d. Call the state board of nursing every week to set up a testing time.

ANS: A To adequately prepare for the NCLEX-RN® examination, the graduate nurse should begin planning early, at least 6 months in advance. The graduate nurse will have received from their nursing program a listing of the filing deadlines for taking the examination. The state board of nursing does not set up the testing time because that is handled by Pearson VUE

What are acceptable forms of identification at the testing center? (Select all that apply.) a. U.S. driver's license b. U.S. state-issued identification c. Credit or debit card with photo identification. d. Passport e. U.S. military identification f. School or university picture identification

ANS: A, B, D, E A U.S. driver's license, U.S. state-issued identification, passport, and U.S. military identification are acceptable forms of identification. (They must be in English, valid, and not expired with a photograph and a signature.) A credit or debit card and school or university identification (even though they have photos) are not acceptable forms of identification at the testing centers.

Which actions by the graduate nurse can help reduce anxiety on testing day? (Select all that apply.) a. Drive to the testing site the day before. b. Evaluate traffic. c. Wait until testing day to drive to the testing site. d. Drive to the hotel the day before. e. Locate the parking area at the testing site.

ANS: A, B, D, E The day before the exam, the student should drive to the testing site, evaluate the traffic, find the parking area, and drive to the hotel (if required to have overnight accommodations) to ease anxiety.

What actions by the graduate nurse will assist with finding the best NCLEX-RN® review book for personal study needs? (Select all that apply.) a. Check the number of pages in various subjects in the material. b. Look up several common topics in the index. c. Look for a book with information that has come out in the past month. d. Look for a book that focuses on nursing concepts. e. Look for a book that focuses on the delivery of safe patient care.

ANS: A, B, D, E When determining which NCLEX-RN® review book is best suited for the student, he or she should check the number of pages in various subjects in the material, look up several common topics in the index to see if information can be found in a timely manner, and look for a book that focuses on nursing concepts and the delivery of safe patient care. Information that has come out in the past month would not yet be available in review books

A nursing professor is preparing students for the NCLEX-RN® Exam. Which of the following items should the professor inform the students to expect on the exam? (Select all that apply.) a. Multiple choice questions with one correct answer b. Drag and drop questions into an ordered response c. True/false questions d. Graphic questions with a hot spot to identify an area e. Questions with an audio component where you need to wear a headset to listen f. Questions where you select the correct answer from the graphics presented at the end of the question

ANS: A, B, D, E, F There are, in addition to multiple-choice questions, alternate format items which consist of the following: • Fill in the blank—short answer usually requires a drug calculation, an intake and output calculation, or an assessment scoring. In these cases, only the numbers should be entered in the space provided. • Multiple-response item—more than four options are presented, and the question will very clearly ask you to select all of the options that correctly answer the question. • Hot spot—presents a diagram or a graphic and requires you to select an area on the diagram to answer the question. • Drag and drop—asked to click on each item and "drag" it to another area of the screen, placing the items, for instance, in the order in which they would be performed or in order of priority of care. • Exhibit item—present a problem and then provide exhibit information stored in tabs. You will click on each tab to find information that will assist you in solving the problem that is presented. The tabs frequently contain information from a chart or data collection from the client. • Audio item—presented with a question that has an audio component in which the test taker puts on the headset provided and click the "Play" button to listen to the audio for the information required to answer the question. • Graphic options—present you with graphics instead of text for the answer options where you will be required to select the correct answer from the graphics presented at the end of the question. Questions are selected for each candidate based on the test plan. When a candidate misses a question, the computer will present an easier question from that same category. There are no "true/false" type questions. Questions are selected for each candidate based on the test plan. When a candidate misses a question, the computer will present an easier question from that same category

What actions will help prepare the graduate nurse for testing success? (Select all that apply.) a. Dress comfortably. b. Stay up late for last-minute studying. c. Eat a balanced breakfast. d. Have identification needed for entrance into the exam. e. Celebrate your success with friends the night before.

ANS: A, C, D To prepare for a successful testing day, the graduate nurse should dress comfortably, eat a balanced breakfast, and have appropriate identification needed for entrance into the exam. Staying up late and celebrating with friends the night before could leave the graduate nurse feeling tired and not prepared for testing.

What questions should the graduate nurse ask themself when determining which NCLEX-RN® examination review course is right for the graduate? (Select all that apply.) a. What review courses are easily accessible? b. What review courses will teach me what I need to know? c. How well do I study at the computer? d. Can I plan a study review schedule and stick to it? e. Can I plan study time?

ANS: A, C, D, E When choosing an NCLEX-RN® examination review courses, the graduate nurse should ask themself the following questions: What review courses are easily accessible? How well do I study at the computer? Can I plan a study review schedule and stick to it? and Can I plan study time? The purpose of the review course is not to teach the material to students but to serve as a review.

A candidate has scheduled to take the NCLEX® Exam and has a family emergency before the scheduled date. What is the best action for the candidate to take? a. Call the respective state board of nursing and request a change in the testing date. b. Call the Candidate Services office at least 24 hours or 1 business day before the scheduled testing day. c. Call the school and request that someone notify the board of nursing regarding your change in schedule. d. It is not necessary to notify anyone regarding rescheduling the testing date; it will be rescheduled automatically.

ANS: B A candidate must notify by either calling or go to the website of the Pearson VUE NCLEX Candidate Services office a full business day (24 hours) before the scheduled testing time to request a change in testing time. The school and respective board of nursing do not participate in the scheduling of the examination. If a candidate does not reschedule within this time frame or does not come at the scheduled testing time, the ATT is invalidated, and the candidate will be required to reregister and repay the $200 registration fee

Which statement made by the graduate nurse indicates understanding of the NCLEX-RN® exam passing score? a. "Candidates seeking licensure in California and New York must score higher." b. "The passing score is the same for licensure in all states." c. "Candidates from BSN programs must score one standard deviation higher than the ADN graduates." d. "ADN graduates must answer 80% of the 265 questions correctly to pass."

ANS: B Every state has the same passing criteria. There is no percentage identified as to the number to get correct. The test has a minimum of 75 questions and a maximum of 265 questions. When the student reaches a passing level of competency or has not reached the passing competency, the test turns off. There is no differentiation in education level or state requirements.

What are helpful strategies for dealing with test anxiety? a. Put as much time as possible into studying. b. Practice relaxation techniques and positive thinking. c. Use review books and tapes. d. Focus on test-taking skills and emphasize facts less.

ANS: B Put yourself in charge of your feelings. Replace those negative thoughts and ideas with positive ones. Practice relaxation and positive thinking and picture yourself succeeding. Picture yourself succeeding. Give yourself permission to take some breaks; studying all of the time will increase anxiety. Review books and tapes assist with the review of important content and do not necessarily deal with test anxiety directly. They may discuss the concept and provide strategies to use, such as the two mentioned in the correct response. Test-taking skills are important for success on NCLEX but do not directly reduce test anxiety.

The graduate nurse is preparing to take the NCLEX-RN® Exam. Which blueprint category is interpreted as having the highest percentage of test items? a. Safe, effective care environment c. Psychosocial integrity b. Physiological integrity d. Health promotion and maintenance

ANS: B The area of physiological integrity makes up about 50% of the test plan. This is the area that covers basic nursing care and comfort, pharmacological and parenteral therapies, reduction of risk potential, and physiological adaptation. Safe, effective care; psychological integrity; and health promotion and maintenance will cover less than this.

The graduate nurse understands the purpose of the NCLEX-RN® exam when stating which of the following? a. "The exam provides feedback to the candidate regarding areas of weakness in nursing practice." b. "The exam determines the candidate's ability or inability to meet minimum standards for safe practice." c. "The exam gives employers an opportunity to hire graduates who have scored highest among first-time licensure candidates." d. "The exam prepares new graduates as efficient, effective staff nurses." .

ANS: B The purpose of the NCLEX-RN® Exam is to determine whether a candidate is competent to perform safe, effective, entry-level nursing care. It does not prepare nurses but rather measures their performance on a test. Candidates who are unsuccessful receive information about their weak areas on the test, but this is not the purpose of it. Employers want to know if the person has passed because there is no specific score given other than pass or fail

A graduate nurse has arrived at the testing center when realizing that the required ATT form is missing. Explain what events would happen next. a. The testing center staff would not be able to look up his ATT online. b. The testing center staff would not allow him to test without his ATT. c. The graduate nurse could be admitted to the testing center with a photo ID. d. The testing center staff would call the NCSBN for verbal approval to let the graduate nurse test.

ANS: B To test, the graduate nurse must present the ATT and photo ID to test. This process will change on January 1, 2014, when the NCLEX testing services will go paperless. The testing center staff will be able to look up the ATT online when the process is paperless. The testing center staff would not call the NCSBN for an approval to test.

What would happen if the graduate nurse failed the NCLEX-RN on the first testing attempt? a. The graduate nurse would be required to take an additional nursing course before retesting. b. The graduate nurse would be required to wait 9 months to retest. c. The graduate nurse would be required to wait 45 to 90 days before retesting. d. The graduate nurse would not be allowed to test again.

ANS: C After failing the NCLEX-RN on the first testing attempt, the graduate nurse would be required to wait 45 to 90 days before retesting. This retake time frame is determined by each state board of nursing and the NCSBN.

What is the best review strategy to use to prepare for the NCLEX-RN® Exam? a. Spend about 8 hours a day on your days off until you take the examination. b. Study for 4 hours a night while taking a 2-week review course. c. Review basic nursing content 2 to 3 hours a day 3 days a week for 5 to 6 weeks. d. Study 10 hours on the day and evening before the examination.

ANS: C Studying 2 to 3 hours a day for 2 or 3 days a week is realistic with frequent breaks during the studying. The new graduate should consider taking the exam within 2 to 3 weeks of obtaining your Authorization to Test. Cramming before the examination will not improve your pass rate. Studying for 8 hours a day is fatiguing and does not necessarily promote retention of the information.

Which statement by the nursing professor is accurate about the NCLEX-RN® exam? The purpose of the NCLEX-RN® test plan is to ensure that all a. "test takers answer items of comparable difficulty." b. "test takers answer approximately the same number of items." c. "test items are job related." d. "clinical specialties will be equally represented."

ANS: C The content of the NCLEX® Exam is based on a test plan that is determined by the National Council. The test plan reflects entry-level nursing practice as identified by research and the job analysis study of newly licensed registered nurses. Each candidate will receive different levels of questions in a computer adaptive format. The focus of the exam is not on clinical specialties. The test has a minimum of 75 questions and a maximum of 265 questions, so a test taker can answer any number of questions between these two numbers until they either reaches a passing standard or fails.

A graduate nurse is planning to travel to a testing site and will need to have overnight accommodations. Which of the following is the best action for this graduate nurse to take to make the stay a success? a. Share a room with the 4 other graduate nurses planning to test at the same testing center. b. Stay up late studying. c. Room alone or with someone who is supportive of a positive environment. d. Room with another graduate nurse who frequently complains..

ANS: C The graduate nurse should consider rooming alone or with someone who is supportive of a positive environment. The graduate nurse will want a good night's rest before the NCLEX-RN® examination. Staying up late studying defeats the purpose of having a restful night before taking the NCLEX-RN® examination`

In trends class, a student tells the instructor, "I don't think I can possibly pass the NCLEX-RN®. I hated psych nursing, but now I've heard that a huge amount of the NCLEX® is psych related." What is the best response from the instructor? a. "Perhaps you should consider retaking the psychiatric nursing course." b. "There are equal numbers of questions related to each aspect of client needs." c. "Psychosocial integrity is the basis for 6% to 12% of the examination." d. "You will need to take a review course in which they teach psychiatric nursing principles."

ANS: C The last detailed test plan (2013) from the National Council designated from 6% to 12% of the total questions to be from the area of psychosocial integrity. The student may not be able to retake nursing courses or a review course. Stating that content area has the same amount of questions would be inaccurate. Each of the categories of client needs has a different percentage, so questions are based on that percentage from the detailed test plan, not on equal numbers from each area. Students often hear incorrect information and rumors about NCLEX.

The graduate nurse has an adequate understanding of the Authorization to Test when stating: a. "The Authorization to Test arrives at the beginning of the last semester of nursing school." b. "The Authorization to Test arrives when the last day of clinical experience is complete." c. "The Authorization to Test arrives upon completion of all of the state and national applications." d. "The Authorization to Test arrives when all course work and applications have been completed and approved."

ANS: D In the beginning of the semester in which the student will graduate, the school of nursing will have each student (candidate) complete an application form and send it to the state board of nursing. Upon completion of the nursing program, the school will verify the candidate's graduate status with the state board of nursing. After the forms have been processed, the candidate will receive an Acknowledgement of Receipt of Registration. The candidate will then receive the Authorization to Test (ATT) with instructions regarding how to schedule the examination with Pearson VUE. The candidate cannot schedule the examination until the ATT is received. Beginning January 1, 2014, the ATT process will become paperless.

The nurse interprets the Nurse Licensure Compact as a. an agreement between all states to recognize the license of all graduate nurses. b. an intrastate agreement for the nurse to practice in any area within the state. c. an agreement between the state boards of nursing and the National Council regarding foreign nurses. d. an agreement between compact states to recognize licensure from member states.

ANS: D Individual states must pass legislation to become members of the Nurse Licensure Compact agreement. After approval within the state legislature, a nurse may practice in one state that belongs to the compact but maintain his or her license in the state of residence

What type of nursing position would most likely provide experience in the type of nursing situations upon which the NCLEX® Exam questions are based? a. Home care nurse b. Psychiatric staff nurse c. Staff nurse in an ambulatory pediatric clinic d. Staff nurse in a medical-surgical inpatient unit

ANS: D The largest percentage of content on the test plan is based on physiologic integrity, which includes basic care and comfort (6%-12%), pharmacologic and parenteral therapies (12%-18%), reduction of risk potential (9%-15%), and physiologic adaptation (11%-17%). Research also shows that the majority of new graduates begin their first job in a hospital medical-surgical environment caring for adult clients.