Test Taking Skills

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Test Taking Skills

Getting Prepared for HESI andNCLEX-RN

Ashley Davis, BSN, RN

Test Taking: Preparing for TestsThe Pyramid to Success

Final Preparation

The PlanPositive Pampering

Maintain A Positive AttitudeShort/Long Term Goals

Develop Control

Test Taking: Preparing for TestsPositive Preparation!

“Whether you think you can, or you thinkyou can’t….you’re right” Henry Ford

Controlled BreathingSit in a comfortable chair, relax, inhale deeply,count to 4, exhale slowly, relax

Visualize your successDesensitize yourself to the fear response

Make a list of 5 situations surrounding testingthat cause fear, rank them from most fearful toleast fearful, starting with least fearful, gothrough each scenario using controlledbreathing and imagery until it no longer causesfear

Test Taking: Preparing for TestPositive Preparation

Muscle RelaxationStart with head, contracting each musclegroup, counting to 10 and then relaxing eachgroup, move from head to toe until allmuscles are relaxed

Develop short-term and long-term goalsthat are realistic

Sit down and practice a few of the relaxationtechniques we just discussedCreate a list of goals that you wish toaccomplish today, tomorrow, and in thefutureSet it aside for a few daysCome back to the list, review it, and beginyour preparation

Test Taking: Preparing for Tests

Positive PreparationDevelop Control

Refrain from using statements like:“I was lucky to pass that test”“I couldn’t help failing because the

teacher is too hard”“I failed because I have test anxiety”

These statements suggest that youhave no control over your successTake responsibility for and controlover your success!

Test Taking: Preparing for Tests

The PlanStart with a Self Assessment

How do I study best?Alone or Group?How long should my study sessions last?What time of day works best?How does my work schedule affect mystudy pattern?How do I balance my family obligations withmy need to study?Where do I study best?

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Test Taking: Preparing for TestsThe Plan

Must include a schedule

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RelaxRelaxRelax?’s?’s?’sRelax

Kids to bedKids to BedKids to bedKids to bedKids to bedKids to bedKids to bed

?’sMovie?’sDinnerDinnerDinnerGroup

?’s?’s?’sWorkWorkWorkGroup

Church?’sGymWorkWorkWorkGo to gym

DinnerDinner withfriends

DinnerWorkWorkWorkDinner

Play TimePlay timeKid’s TimeWorkWorkWorkKid’s Time

ContentContentNapWorkWorkWork?’s

?’s?’sContentWorkWorkWork?’s

?’s?’sContentWorkWorkWorkNap

NapNapMovieWorkWorkWorkLunch

LunchLunchMovie with friendWorkWorkWorkContent

ChurchPark?’sWorkWorkWork ?’s

ChurchPark with kids?’sWorkWorkWork ?’s

BreakfastBreakfastBreakfastWorkWorkWorkBreakfast

SundaySaturdayFridayThursdayWednesdayTuesdayMonday

Test Taking: Preparing for TestsFinal Preparation

Think positivelyWrite your name with RN behind it and post it where you willsee it often

Make a test run to the testing siteWalk into the lobby and visualize being successful

Stop studying 2 days before you are scheduled to testGood Nights SleepEat BreakfastSet your alarm earlyAvoid Conversations

Test Taking: Preparing for TestsAlternate Item Formats which now appearon NCLEX-RN

Multiple-Response Items: require a candidate toselect one or more responsesFill-in-the-blank Items: require candidate to typein a calculation itemHot-Spot Items: ask a candidate to identify anarea on a picture or graphicChart/Exhibit Format: candidates will bepresented with a problem and will need to readthe information in the chart/exhibit to answer theproblemDrag-and-drop Item: requires a candidate torank order or move options to provide thecorrect answer

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Test Taking StrategiesHow to conquer the question

Components of a QuestionCase Scenario- May give you informationabout a clinical problem, present you withpatient data, or it may state a nursing topic,such as nursing intervention or a diseaseprocess.Stem- This asks you to solve a specificproblemFour Possible Answers

Test Taking StrategiesPractice

The nurse is monitoring a child for bleedingfollowing surgery for removal of a brain tumor.The nurse checks the head dressing for thepresence of blood and noted a colorless drainageon the back of the dressing. Which of thefollowing would be the most appropriate nursingintervention?1. Circle the area of drainage and continue to monitor2. Reinforce the dressing3. Notify the physician4. Document the findings and continue to monitor

Test Taking StrategiesCase Scenario

The nurse is monitoring a child for bleeding following surgeryfor removal of a brain tumor. The nurse checks the headdressing for the presence of blood and noted a colorlessdrainage on the back of the dressing. Which of thefollowing would be the most appropriate nursingintervention?

1. Circle the area of drainage and continue to monitor2. Reinforce the dressing3. Notify the physician4. Document the findings and continue to monitor

Test Taking StrategiesStem

The nurse is monitoring a child for bleeding following surgeryfor removal of a brain tumor. The nurse checks the headdressing for the presence of blood and noted a colorlessdrainage on the back of the dressing. Which of thefollowing would be the most appropriate nursingintervention?1. Circle the area of drainage and continue to monitor2. Reinforce the dressing3. Notify the physician4. Document the findings and continue to monitor

Test Taking StrategiesHow to conquer the question

After reading the question ask:What is the question telling me?What is the question asking me?Who is the patient in the question?Are there any key words?What is the issue?


What is the question telling me?What is the question asking me?Look at the stem:The nurse is monitoring a child for bleeding following surgery

for removal of a brain tumor. The nurse checks the headdressing for the presence of blood and noted a colorlessdrainage on the back of the dressing. Which of thefollowing would be the most appropriate nursingintervention?

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Who is the patient in the question?Who is the focus of the question?You must identify the client in the questionbecause the answer MUST relate to the clientThe client is NOT always the patient, itsometimes is a family member.


Who is the patient in the question?The nurse is monitoring a child for bleeding

following surgery for removal of a brain tumor.The nurse checks the head dressing for thepresence of blood and noted a colorlessdrainage on the back of the dressing. Which ofthe following would be the most appropriatenursing intervention?


Are there any key words?The important phrases or words in a question:

EarlyLateImmediatelyMost Likely, Least LikelyInitialAfter Several DaysMost Appropriate/Least AppropriatePriority/First

Test Taking StrategiesPractice: Key Words

A nurse is caring for a client who just returnedfrom the recovery room after undergoingabdominal surgery. The nurse monitors theclient for which early sign of hypovolemicshock?Increased pulse rateIncreased depth of respirationLethargyDecreased deep tendon reflexes


What is the issue?The specific problem or subject which the questionis ASKING

DrugToxic EffectDisorderProblemBehaviorProcedure

Test Taking StrategiesPractice: The Issue

Fat emulsion is prescribed for the client receiving totalparenteral nutrition. The nurse is preparing to hangthe fat emulsion and notes the presence of fatglobules in the solution. The most appropriatenursing action is toShake the solution to dissolve the globulesCall the physicianReturn the solution to the pharmacyPlace the solution in a bath of warm water until theglobules dissolve

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Test Taking StrategiesAfter Reading the Question

Cover up the answers and answer the questionyourselfRead each answer individuallyMark off all answers that for sure are incorrectQuestion mark the maybesDo not read information into the questions that wasnot given to you- Do Not Ask “ Well What If..”

Go back to the questionRestate the question in your own wordsEliminate options that include “new” information or requireyou to make assumptions

Test Taking StrategiesAfter Reading the Question

It is always best to rely on your firstimpressionNervously reviewing questions andchanging answers can do more harm thangood

Test Taking StrategiesQuestions that require Prioritization

Look for key words in the question that indicate the need toprioritize

BestEssentialFirstHighest PriorityImmediatelyInitialMost ImportantNextPrimaryVital

Remember, when a question requires prioritization, all optionsmay be correct, and you need to determine the correct order ofactionGuidelines to use include the ABC’s, Maslow’s hierarchy ofneeds theory, and the steps of the Nursing Process

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The ABC’sAirwayBreathingCirculation

The client with a diagnosis of cancer is receiving morphine sulfate10mg subcutaneously every 3-4 hours for pain. When preparingthe plan of care for the client, the nurse includes which priorityaction?Monitor stoolsMonitor the urine outputEncourage the client to cough and deep breathEncourage fluid intake

Test Taking StrategiesQuestion that require Prioritization

Maslow’s Hierarchy of Needs TheoryPhysiological needs are the priority; thereforeselect an option or determine the order of priorityby addressing physiological needs first.When a physiological need is not addressed inthe question or noted in one of the options,continue to use Maslow’s hierarchy of needstheory as a guide and look for the option thataddresses safety


Maslow’s Hierarchy of NeedsA nurse is reviewing the plan of care for a pregnant

client with a diagnosis of sickle cell anemia. Whichnursing diagnosis, if stated on the plan of care,would the nurse select as receiving the highestpriority?AnxietyIneffective copingDisturbed body imageDeficient fluid volume


Steps of the Nursing ProcessAssessmentAnalysisPlanningImplementationEvaluation

Test Taking StrategiesAssessment

Assessment questions address the process ofgathering subjective and objective data relative tothe client, confirming that data, and communicatingand documenting the dataKey words that reflect Assessment

AscertainAssessCheckFind outIdentifyMonitorObserveObtain information

Test Taking StrategiesAssessment

If an option contains the concepts of assessment or thecollection of client data, the best choice is to select thatoptionPossible exception to the guideline: If the questionpresents an emergency situation, read carefully; in anemergency situation, an intervention may be priority.

A nurse is teaching a client with coronary artery disease about dietarymeasures to follow. During the session, the client expressesfrustration in learning the dietary regimen. The nurse wouldinitiallyIdentify the cause of the frustrationContinue with the dietary teachingNotify the physicianTell the client that the diet needs to be followed

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Test Taking StrategiesAnalysis

Analysis questions are the most difficult becausethey require understanding of the principles ofphysiological responses and require interpretationof the data based on assessment.Analysis questions require critical thinking anddetermining the rationale for therapeuticinterventions that may be addressed in thequestion.Analysis questions may address the formulation ofa nursing diagnosis and the communication anddocumentation of the results of the process ofanalysis.

Test Taking StrategiesAnalysis

A nurse is reviewing the laboratory results of aninfant suspected of having hypertrophicpyloric stenosis. Which of the followinglaboratory findings would the nurse mostlikely expect to note in this infant?A blood pH of 7.50A blood pH of 7.30A blood bicarbonate of 22mEq/LA blood bicarbonate of 19mEq/L

Test Taking StrategiesPlanning

Planning questions require prioritizing nursing diagnoses,determining goals and outcome criteria for goals of care,developing the plan of care, and communicating anddocumenting the plan of care.Regarding nursing diagnoses, remember that actual clientproblems rather than potential or at-risk client problems willmost likely be the priority. Exceptions to this would be if theproblem addresses the ABCs or, in some cases, Maslow’sHierarchy of Needs.Remember that this is a nursing exam and the answer to thequestion most likely involves something that is included inthe nursing care plan, rather than the medical plan.

Test Taking StrategiesPlanning

A nurse develops a plan of care for a client with acataract. Which nursing diagnosis is the priority?Fear related to loss of eyesightSocial isolation related to decreased ability tomobilize in the communityDisturbed Sensory Perception (Visual) related toocular lens opacityRisk for injury related to decreased vision

Test Taking StrategiesImplementation

Implementation questions address the process of organizationand managing care, counseling and teaching, providing care toachieve established goals, supervising and coordinating care,and communicating and documenting nursing interventions.This exam is about nursing, so focus on the nursing actionrather than on the medical action, unless the question is askingyou what prescription (medical order) is anticipated.The only client about whom you need to be concerned us theclient in the question that you are answering; remember thatthis client is your only assigned client.Answer the question as if the situation were textbook and idealand the nurse had all the time and resources needed andreadily available at the client’s bedside.

Test Taking StrategiesImplementation

A nurse is caring for a client with a angina pectoris whobegins to experience chest pain. The nurseadministers a sublingual nitroglycerin (Nitrostat)tablet sublingually as prescribed, but the pain isunrelieved.The nurse should take which of thefollowing actions next?Contact the physicianCall the client’s familyAdminister another nitroglycerin tabletReposition the client

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Test Taking StrategiesEvaluation

Evaluation questions focus on comparing the actual outcomesof care with the expected outcomes and focus on how thenurse should monitor or make a judgment concerning a client’sresponse to therapy or to a nursing action.These questions address evaluating the client’s ability toimplement self-care, health care team members’ ability toimplement care, and the process of communicating anddocumenting evaluation findings.In an evaluation question, be alert to false response questionsbecause they are used frequently in evaluation-type questions,and the question may ask for a client statement that indicatesaccurate or inaccurate information related to the issue of thequestion.

Test Taking StrategiesEvaluation

A client with multiple sclerosis has been takingoxybutynin (Ditropan). The nursedetermines the degree of effectiveness ofthe medication by asking the client aboutchanges in the following:Extent of muscle spasmsLevel of fatigueBowel movementsPatterns of urination

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Test Taking StrategiesQuestions that address Client Needs

Physiological IntegritySafe, Effective Care EnvironmentPsychosocial IntegrityHealth Promotion and Maintenance

Test Taking StrategiesPhysiological Integrity

These questions address the nurse’s role in the promotingphysical health and well-being in the client by providing careand comfort, reducing client risk potential, and managing theclient’s health alterations.Content addressed in the questions relates to basic care andcomfort, pharmacological and parenteral therapies, reducingthe risk of development of complications, and managing andproviding care to clients with acute, chronic, or life-threatening conditions.Remember that physiological needs are a priority and areaddressed first.Use the ABC’s; Maslow’s theory; and the steps of thenursing process when selecting an option addressingphysiological integrity.

Test Taking StrategiesSafe, Effective Care Environment

These questions address the nurse’s role in providing anddirecting care that will ensure an environment that promotesprotecting the client, family and significant other(s), andother health care professionals.Content addressed in these questions relates to the nursingrole of coordinating and integrating cost-effective care,supervising and /or collaborating with members of themultidisciplinary health care team, and environmental safety.Be alert to safety needs addressed in a question, andremember the importance of hand washing, call lights, bedpositioning, and the appropriate use of side rails, andstandard precautions.

Test Taking StrategiesPsychosocial Integrity

These questions address the nurse’s role in providingnursing care that supports and promotes the emotional,mental, and social well-being of the client and significantother(s).Content addressed in these questions relates to promotingthe client’s or significant other’s ability to cope, adapt, orproblem solve in situations such as illness or stressful eventsand to providing care to clients with maladaptive behavior oracute or chronic mental illness.In this Client Needs category you may be askedcommunication-type questions that relate to how you wouldrespond to a client, a client’s family member or significantother, or to other health care team members.


Use therapeutic communication techniquesto answer communication questionsbecause of their effectiveness in thecommunication process.Remember to select the answer thatfocuses on the client’s, client’s familymember’s, or significant other’s feelings,concerns, anxieties, or fears.


Communication ToolsBeing Silent: Sitting quietlyOffering Self: “Let me sit with you.”Showing Empathy: “You are upset.”Focusing: “You say that…”Restatement: “You feel anxious?”Validation/Clarification: “What you are saying is …”Giving Information: “Your room is 423.”Dealing with the Here and Now: “At this time, theproblem is…..”

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Communication BlocksGiving Advise: “If I were you, I would…”Showing Approval/Disapproval: “You did the right thing.”Using Clichés and False Assurances: “Don’t worry, it willbe okay”Requesting an Explanation: “Why did you do that?”Devaluating Client Feelings: “Don’t be concerned. It’s not aproblem.”Being Defensive: “Every nurse on this unit is exceptional!”Focusing on Inappropriate Issues or Person: “Have I saidsomething wrong?”Placing the Client’s Issues on Hold: “Talk to your doctorabout that.”


Rules-of-Thumb for Communication QuestionsNEVER answer “I”Always focus on feelings, thoughts, and behaviorsUsually the answer with “you feel” is correct.Always remember it is about the client.

A mother says to the nurse, “I am afraid that my childmight have another seizure.” Which response by thenurse is most therapeutic?“Why worry about something that you cannot control?”“Most children will never experience a second seizure.”“Tell me what frightens you the most about seizures.”“Acetaminophen (Tylenol) can prevent another seizurefrom occurring.”

Test Taking StrategiesHealth Promotion and Maintenance

These questions address the nurse’s role in providing anddirecting nursing care that prevents health problems,provides early detection of health problems, and providesand directs care that incorporates knowledge of expectedgrowth and development principles.Content addressed in these questions relates to assisting theclient and significant other(s) through the normal stages ofgrowth and development and assisting the client andsignificant other(s) to develop health practices that promotewellness and to recognize alterations in health care status.Use the teaching/learning theory if the question addressesclient education, remembering that client motivation andclient readiness to learn is the first priority.Be alert to false response questions that address healthpromotion and maintenance and client education.

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Test Taking StrategiesNarrowing Down My Options

Eliminating Similar OptionsWhen answering the question, use the processof elimination and look for similar options.If any of the options include the same idea,then they are incorrect and can be eliminated.Remember that there is only one correct option,and the answer to the question is the optionthat is different.

Test Taking StrategiesEliminating Similar Options

A nurse is assigned to care for a group of clients. Onreview of the clients’ medical records, the nursedetermines that which client is at risk for excessfluid volume?The client with an ileostomyThe client taking diureticsThe client who requires gastrointestinal suctioningThe client with renal failure


Eliminate Options That Contain Absolute Words.As you reach each option, look for absolute words.Absolute words tend to make an option incorrect, and ifyou note an absolute word in an option, eliminate thatoption.Absolute Words include:

AllAlwaysEveryMustNoneNeverOnly

Test Taking StrategiesEliminate options that contain absolutewords

A nurse is providing safety instructions to the mother ofa child with hemophilia and tells the mother to dowhich of the following to promote a safeenvironment for the child?Remove toys with sharp edges from the child’s toyboxAllow the child to play with toys only if a parent ispresentPlace a helmet and elbow pads on the child everydayAllow the child to play indoors only.


Look for the Umbrella OptionsWhen answering a question, if you note thatmore than one option appears to be correct,look for the umbrella option (also known as theglobal option or comprehensive option)The umbrella option is the one that is a generalstatement and may contain the ideas of theother options within it.The umbrella option will be the correct answer.

Test Taking StrategiesLook for the Umbrella Option

A nurse in the emergency room receives a telephone call from theemergency medical services and is told that several victimswho survived a plan crash and are suffering from coldexposure will be transported to the hospital. The initial nursingaction of the emergency room nurse is which of the following?Supply the trauma rooms with bottles of sterile water andnormal saline.Call the laundry department and ask the department to sendas many warm blankets as possible to the emergency room.Call the nursing supervisor to activate the agency disasterplan.Call the intensive care unit to request that nurses be sent tothe emergency room.

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Test Taking StrategiesHow to Answer Delegation/ Assignment-making Questions

You may be asked a question that will require you to decidehow you will delegate a task or assign clients to other healthcare providers.Focus on the information in the question and what task orassignment is the be delegated.Once you have determined what task or assignment is to bedelegated, consider the client’s needs and match the client’sneeds with the scope of practice of the health care providersidentified in the question.The nurse practice act and any practice limitations definewhich aspects of care can be delegated and which must beperformed by the registered nurse.

Test Taking StrategiesHow to Answer Delegation/ Assignment-makingQuestions

Generally, noninvasive interventions such as skin care, range ofmotion exercises, ambulation, grooming, and hygiene measurescan be assigned to a nursing assistant.A licensed practical nurse can perform the tasks that a nursingassistant can perform and additionally can perform certaininvasive tasks such as dressings, suctioning, urinarycatheterization, and administering medications orally or bysubcutaneous or intramuscular injections.The registered nurse can perform the tasks that a licensedpractical nurse can perform an is responsible for assessmentand planning care, supervising care, initiating teaching, andadministering medications intravenously.

Test Taking StrategiesAnswering Delegation/ Assignment-MakingQuestions

A nurse is planning the client assignments for the day and has alicensed practical nurse (LPN) and a nursing assistant in thenursing team. Which client would the nurse most appropriatelyassign to the LPN?A client with stable congestive heart failure who has earlystage of Alzheimer’s disease.A client who was treated for dehydration and is weak andneeds assistance with bathing.A client with emphysema who is receiving oxygen at 2 Lpm bynasal cannula and becomes dyspneic on exertion.A client who is scheduled for an electrocardiogram and a chestx-ray.

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Test Taking StrategiesAnswering Pharmacology Questions

If you are familiar with the medication, use nursingknowledge to answer to question.Remember that the question will identify the generic nameand the trade name of the medication.If the question identifies a medical diagnosis, then try tomake a relationship between the medication and thediagnosis; for example, you can determine thatcyclophosphamide (Cytoxan) is an antineoplastic medicationif the question refers to a client with breast cancer who istaking this medication.


Try to determine the classification of the medication beingaddressed to assist in answering the question; identifying theclassification will assist in determining a medication action andside effects (diltiazem {Cardizem} is a cardiac medication).Recognize the common side effects associated with eachmedication classification and then relate the appropriate nursinginterventions to each side effect; for example, if a side effect ishypertension, then the associated nursing intervention would beto monitor the blood pressure.Learn medications that belong to a classification bycommonalities in their medication names; for example,medications that are xanthine bronchodilators end with “line”(theophylline).


Look at the medications that belong name and use medicalterminology to assist in determining the medication action;for example, Lopressor lowers (lo) the blood pressure(pressor).If the question requires a medication calculation, rememberthat a calculator is available on the computer; talk yourselfthrough each step to be sure the answer makes sense, andrecheck the calculation before answering the question,particularly if the answer seems like an unusual dosage.


Points to RememberGenerally, the client should not take an antacidwith medication because the antacid will affectthe absorption of the medicationEnteric-coated and sustained-release tabletsshould not be crushed; additionally, capsulesshould not be opened.The client should never adjust or change amedication dose or abruptly stop taking amedication.The nurse never adjusts or changes the client’smedication dosage and never discontinues amedication.


Points to RememberThe client needs to avoid taking over-the-counter medications or any other medicationssuch as herbal preparations unless they areapproved for use by the health care provider.The client needs to avoid alcohol and smokingMedications are never administered if the orderis difficult to read, is unclear, or identifies amedication dose that is not a normal one.


Orally administered levothyroxine (Synthroid) 50mcgdaily is prescribed for a client with hypothyroidism.The nurse provides medication instructions to theclient and tells the client to take the medication:Just after breakfastWith a snack at 3 PMIn the morning on an empty stomachWith food

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2007 NCLEX-RN Test Plan

6-12%13-19%13-19%11-17%

Physiological IntegrityBasic Care and ComfortPharmacological and Parenteral TherapiesReduction of Risk PotentialPhysiological Adaptation

6-12%Psychosocial Integrity

6-12%Health Promotion and Maintenance

13-19%8-14%

Safe Effective Care EnvironmentManagement of CareSafety and Infection Control

Percentage of ItemsNCLEX-RN Client Need

NCLEX-RNWhat is the NCLEX Examination?

In April 1994 nurse licensure candidates begantaking the Nation Council Licensure Examination(NCLEX) on a computer at test centers locatedacross the United States and select internationalsites.The change to computerized adaptive testing(CAT) for the nurse licensure examination cameabout as a result of a decision made in August1991 by the National Council of State Boards(NCSBN).

NCLEX® is aComputerized Adaptive Test

(CAT)

How Does It Work?

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Every time the examinee answers aquestion, the computer re-estimates theexaminee’s ability.

With every additional answer, the abilityestimate gets more precise.

Based upon the most recent, revisedability estimate, the computer selectsthe next item to be presented, such thatthe examinee will find it challenging.(Not too hard, Not too easy)

This way an adaptive test presents theexaminee with the items that will be themost informative for measuring ability.

Each test is tailored to the examinee.

Tailoring a Test with CAT…

Reduces the number of easy items that high-ability examinees receive.

Easy items tell little about a high performer’s ability

Reduces the number of difficult items that low-ability people receive.

People guess on items that are too difficult for them.

The item selection algorithm selectswhich item the examinee will see next.

Items are selected for examinees from alarge pool of items using three criteria.

Selection Criteria OneFirst, the algorithm excludes any itemthat the examinee has seen in the lastyear.

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Second, the algorithm limits the selection toitems from the content area (sub-need) thatwill produce the best match to the test planpercentages.

The algorithm ensures that each person’stest has enough questions from eachcontent area to match the test plan.

Selection Criteria Two

Third, the algorithm selects an item that theexaminee is expected to find challenging.

Based upon the examinee’s answers up to thatpoint, the computer estimates the examinee’sability and selects an item that the examineeshould have about a 50% chance of gettingright.

Selection Criteria Three

When is the Test Over?The NCLEX has a minimum and maximumnumber of items that can be asked.

RN: 75 – 265PN: 85 – 205

The test ends when the computer determineswith 95% certainty that the examinee’s abilityis either above or below the passingstandard.

The test can also end if the examineeruns out of time or answers themaximum number of questions.

RN: 265PN: 205

When is the Test Over?

Did I Pass or Fail?

These decisions are governed by threerules. They are evaluated in this order:

Rule #1: the 95% confidence ruleRule #2: the maximum-length test ruleRule #3: the ran-out-of-time rule

Rule #1: 95% ConfidenceThis rule governs most (90%+) of thecases.

The computer will stop administeringquestions when it is 95% certain thatthe examinee’s ability is either aboveor below the standard.

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Ability estimates below the standard arefailures.

Ability estimates above the standard arepassers.

Rule #2: Maximum LengthTest

If the maximum number of items havebeen answered, and the computer stillisn’t 95% certain of whether theexaminee’s ability is above or below thepassing standard, then the 95%certainty requirement is dropped.

Ability estimates at or below thestandard are failures.

Ability estimates above the standard arepasses.

Rule #3: Ran Out of Time

The computer stops administeringquestions after the allotted time haspassed.

If fewer than the minimum number of itemswere answered, the examinee fails.

If at least the minimum number of items wereanswered and the examinee’s ability estimatewas consistently above the standard over thelast 60 items, then the examinee passes.

If the minimum number of items were answeredbut the examinee’s ability estimate droppedbelow the standard even once over the last 60items, then the examinee fails.

This does not mean that you must get thelast 60 correct to pass.

In fact, the adaptive nature of the testalmost ensures that you will only getabout half of the questions correct.

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Rule #2 (maximum length tests) &Rule #3 (ran out of time) are essentially“second chances” to pass.

These rules are only invoked becausethe person’s status was ambiguous(less than 95% certain)

Questions About How CATworks?

Please ContactNational Council of State Boards of Nursing,Inc. (NCSBN)

Thomas O’Neill, Ph.D.Associate Director of Testing Services -PsychometricsPhone: (312) 525-3620E-mail: [email protected]


(CAT)Example:

A RN Candidate – Passing

Minimum RN test length is 75 items(60 operational + 15 pretest)

Maximum RN test length is 265 items(250 operational + 15 pretest)

Six hours are allotted to complete thetest

Test Length

The passing standard is -0.28, in this example.

Pretest items are excluded from this example.

The blue lines are the examinee’s abilityestimate.

The red lines are the 95% confidence interval.

Example: RN Examinee -Passing

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Begin to evaluate Pass-Fail status

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We are 95% certain that the examinee’strue ability is above the passing standard.

Examinee Passes

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-2.00

-1.50

-1.00

-0.50

0.00

0.50

1.00

1.50

2.00

0 10 20 30 40 50 60 70 80 90 100 110 120

Item

Abi

lity


Please ContactNational Council of State Boards ofNursing, Inc. (NCSBN)



(CAT)Example:

A RN Candidate – Failing

Test Length

Minimum RN test length is 75 items(60 operational + 15 pretest)

Maximum RN test length is 265 items(250 operational + 15 pretest)

Six hours are allotted to complete thetest

Example: RN Examinee -Failing

The passing standard is -0.28, in this example.

Pretest items are excluded from this example.

The blue lines are the examinee’s abilityestimate.

The red lines are the 95% confidence interval.-2.00

-1.50

-1.00

-0.50

0.00

0.50

1.00

1.50

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0 10 20 30 40 50 60 70 80 90 100 110 120

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Abi

lity

22

-2.00

-1.50

-1.00

-0.50

0.00

0.50

1.00

1.50

2.00

0 10 20 30 40 50 60 70 80 90 100 110 120

Item

Abi

lity pass

fail

-2.00

-1.50

-1.00

-0.50

0.00

0.50

1.00

1.50

2.00

0 10 20 30 40 50 60 70 80 90 100 110 120

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Abi

lity

-2.00

-1.50

-1.00

-0.50

0.00

0.50

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0 10 20 30 40 50 60 70 80 90 100 110 120

Item

Abili

ty

-2.00

-1.50

-1.00

-0.50

0.00

0.50

1.00

1.50

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0 10 20 30 40 50 60 70 80 90 100 110 120

Item

Abi

lity

-2.00

-1.50

-1.00

-0.50

0.00

0.50

1.00

1.50

2.00

0 10 20 30 40 50 60 70 80 90 100 110 120

Item

Abi

lity

-2.00

-1.50

-1.00

-0.50

0.00

0.50

1.00

1.50

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0 10 20 30 40 50 60 70 80 90 100 110 120

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Abi

lity

23

-2.00

-1.50

-1.00

-0.50

0.00

0.50

1.00

1.50

2.00

0 10 20 30 40 50 60 70 80 90 100 110 120

Item

Abi

lity

-2.00

-1.50

-1.00

-0.50

0.00

0.50

1.00

1.50

2.00

0 10 20 30 40 50 60 70 80 90 100 110 120

Item

Abi

lity Begin to evaluate Pass-Fail status

Examinee Fails

We are 95% certain that the examinee’strue ability (as demonstrated at this time)is below the passing standard.

-2.00

-1.50

-1.00

-0.50

0.00

0.50

1.00

1.50

2.00

0 10 20 30 40 50 60 70 80 90 100 110 120

Item

Abi

lity Begin to evaluate Pass-Fail status


Please ContactNational Council of State Boards ofNursing, Inc. (NCSBN)


24

NCLEX-RNRegistration Process

Submit an application for licensure to the boardof nursing where you which to be licensed (willdo with Mrs. Anderson)Meet all of the Board of Nursing’s eligibilityrequirements to take the NCLEX examination.Register for the NCLEX Examination withPearson VUEReceive Confirmation of Registration fromPearson VUEThe board of nursing makes the candidateeligible to take the NCLEXReceive Authorization to Test (ATT) fromPearson VUE

NCLEX-RNRegistration Process

If you choose to provide an e-mail address,you will receive ALL information via e-mail.If you do not provide an e-mail address,you will receive ALL information via U.S.mail.

NCLEX-RNExamination Fee and RegistrationInformation

The fee for taking the NCLEX exam is $200. Youmay also have to pay fees for licensure requiredby the board of nursing in the jurisdiction in whichyou are applying.All NCLEX examination registrations will remainopen for 365-day time period during which a boardof nursing may determine the candidate’s eligibility.The time period begins when the board of nursingreceives the candidate’s registration from the testservice.Once a candidate is made eligible, he/shemust test within the validity dates printed on theAuthorization to Test (ATT).

25

NCLEX-RNHow to Register

InternetMailTelephone

There will be no refund of registration fees forany reason!

Once you have been cleared through Baptist andthe State Board, you will receive yourAuthorization to Test (ATT)

NCLEX-RNHow to Schedule your NCLEX ExaminationAppointment

Your ATT contains your:Test authorization numberCandidate identification numberExpiration date- you must test before your expiration date,these dates can not be changed for any reason.

You must have your ATT to schedule yourappointment to take the NCLEX examination.You must also have you ATT with you at thetesting center the day that you take the NCLEXexamination

NCLEX-RNThe Big Day

Personal Identification: you must presentone form if identification with your ATT atthe testing center the day you show up totest.

U.S. Driver’s LicenseU.S. State IdentificationPassportThe name printed on your identification mustmatch exactly the printed name on your ATT

NCLEX-RNThe Big Day

Additional PrecautionsA digital fingerprint, signature and photograph will betaken at the test center and will accompany yourexamination results. Your fingerprint, signature andphotograph may be used to confirm your identity by theboard of nursing to which you have applied for licensure.You cannot be tested without having your fingerprint,signature and photograph taken.You will be observed at all times while taking theexamination. This observation will include directobservation by the test center staff as well as video andaudio recording of your examination session.

NCLEX-RNThe Big Day

Test Center RegulationsNo study aids (textbooks, notebooks, classroom notes,etc.) are allowed anywhere in the Pearson ProfessionalCenters.No papers, books, food, pens, purses, wallets, watches,beepers, cell phones or any other electronic devices areallowed in the testing room.No cameras, photographic equipment or devices areallowed in the test center.No hats, scarves, or coatsEating, drinking or use of tobacco is not allowed in thetesting center.Unauthorized scratch paper may not be brought into thetesting room.

NCLEX-RNThe Big Day

Test Center RegulationsNote boards and markers will be provided bythe test center staff. Note boards may not beremoved from the test center.Candidates may not leave the testing roomwithout the test administrator’s permission.Candidates must provide a fingerprint eachtime they enter and exit the testing room.

26

NCLEX-RNThe Big Day

Grounds for Dismissal or Cancellation of ResultsGiving or receiving assistance of any kindUsing any prohibited aids. Prohibited aids are anydevices or materials that will be helpful in taking heNCLEX examination. Examples of aids that areprohibited are handheld calculators, conversion tables,dictionaries, etc.Attempting to take the examination fro someone elseBringing any NCLEX examination study materials to thetesting center or accessing or attempting to access suchstudy materials at any time after the start of theexamination administration, including, but not limited to,break times.

NCLEX-RNThe Big Day

Grounds for Dismissal or Cancellation of ResultsFailing to follow testing regulations or the instructions ofthe test administratorCreating a disturbance of any kindCopying, reconstructing, or removing examination itemsand/or responses (in any format) or notes about theexamination from the testing room or attempting to do thesame.Tampering with the operation of the computer orattempting to use it for any function other than taking theexamination

NCLEX-RNThe Big Day

Plan to arrive at the Pearson Professional Center at least30 minutes before your scheduled testing time. If youarrive more than 30 minutes after your scheduledappointment, you may be required to forfeit you NCLEXexamination appointment.Friends, relatives or children who accompany you to thetest center will not be permitted to wait in the test center orcontact you while you are taking the examinationYou will be required to present your ATT and your validpicture ID in English that includes your signature inEnglishYou will be asked to provide your signature, and you willhave your fingerprint and photograph taken. Hats, scarvesand coats may not be worn in the testing room or whileyour photograph is being taken.

NCLEX-RNThe Big Day

You will be required to leave your personal belongingsoutside the testing room. Secure storage will be provided.Storage space is small, so candidates should planappropriately. Pearson Professional Centers assume noresponsibility for candidates’ person belongings.The test administrator (TA) will provide you with an erasablenote board that may be replaced as needed during testing.You may not take your own note boards, scratch paper orwriting instrument to the examination, not may you removethe note board from the testing room at any time. Turn yournote board to the TA after you complete the testing.You will have up to six hours to complete the NCLEXexamination. Total exam time includes a short tutorial, twopreprogrammed optional breaks and any unscheduledbreaks you may take. The first optional break is offered aftertwo hours of testing. The second optional break is offeredafter three and one half hours of testing. The computer willautomatically tell you when these scheduled breaks begin.

NCLEX-RNThe Big Day

The TA will give you a short orientation and then willescort you to a computer terminal. You must remain inyour seat during the examination, except when authorizedto leave by the test center staff. You may not change yourcomputer terminal unless a TA directs you to do so.Raise your hand to notify the TA if you:

Believe you have a problem with your computerNeed to change note boardsNeed to take a breakNeed the TA for any reason

After your examination is finished, you will be asked tocomplete a brief computer-derived questionnaire aboutyour testing experience

NCLEX-RNThe Big Day

When you have finished the questionnaire, raiseyour hand to summon the TA. The TA will collectand inventory all note boards. The TA willdismiss you when all requirements are fulfilled.You may ask the TA for a Confidential CommentSheet for any narrative information about yourtesting session you want to provide to NCSBN,the Pearson Professional Centers or NCLEXCandidate Services.

27

28

SourcesManning, L. & Rayfield, S. (1997). Nursing Made

Insanely Easy. Shreveport: ICAN, Inc.Nugent, P.M. & Vitale, B.A. (2004). Empowerment. Test

Success: Test-Taking Techniques for BeginningNursing Students. (pp 1-8). Philadelphia: F.A. DavisCompany.

Silvestri, L.A. (2005). Saunders Comprehensive Reviewfor the NCLEX-RN Examination. St.Louis: Elsevier.

Documents

Test Taking Skills