Tuesday, October 30, 2007

The Ultimate Guide to the NCLEX Exam

The National Council Licensure Examination for Registered Nurses (NCLEX-RN) and the National Council Licensure Examination for Practical Nurses (NCLEX-PN) are test plans used by state and territorial boards of nursing to assist in determining licensure decisions. In order to become a nurse, you must pass one of those two exams. While the pressure is on to pass the test, the following information might make the whole process much easier for you.

If you realize that one organization, National Council of State Boards of Nursing (NCSBN), develops both licensure examinations, you might then understand that this is the source for all your research into the NCLEX. Beyond this, some simple requirements include registration, as you must apply for a nursing license from your state board of nursing. That board will determine whether or not you meet their criteria for NCLEX exam eligibility. Once you've passed eligibility, you must register to take the exam - or, in other words - apply for a license to practice nursing.

Once you register, you'll receive an NCLEX Examination Candidate Bulletin in the mail or by email. This bulletin allows you to register with the NCSBN's testing service (see instructions below). You'll also receive an ATT (Authorization to Take the Test), along with a list of testing centers and instructions for how to schedule a time to take the exam. From this point, the only thing you need to do is pass the exam! That's where we come in, to help you simplify this otherwise stressful event.
NCLEX Test Plan Structures

The National Council of State Boards of Nursing (NCSBN) develops the two licensure examinations mentioned in the introduction. Therefore, it might behoove you to look to this agency for guidance in taking these exams. As explained in the link provided for NCSBN, their committees, subcommittees and staff prepare the items for the tests and contracts with Pearson VUE for test development and administration of the NCLEX examinations. This is a fairly new partnership and it will extend through 2014.

The link for Pearson VUE above will take you directly to the page where you can schedule your NCLEX exam. This page also contains an online tutorial for both NCLEX test plans. This tutorial is the same for both the NCLEX-RN and NCLEX-PN, and you will need a Windows PC to operate this tutorial. When you click "Play Tutorial," a "File Download" box will appear. Click "Open" and the windows application will download to your PC. Once the installation completes, the guided tour and tutorial will open automatically and you may begin to practice for your exams.

According to the NCSBN, the NCLEX-RN test plan [PDF] categories all reflect client needs across the life span in a variety of settings. Under this broad topic, you'll find four major categories of Client Needs that organize the content within the test plan. Two of the four categories are further divided into a total of six subcategories. The Client Needs categories and subcategories that define the content of the NCLEX-RN Test Plan include ("Health promotion and maintenance" and "Psychosocial Integrity" categories do not have subcategories):

Safe Effective Care Environment

* Management of Care: 13% - 19%
* Safety and Infection Control: 8% - 14%

Health promotion and maintenance: 6% - 12%

Paychosocial Integrity: 6% - 12%

Physiological Integrity

* Basic Care and Comfort: 6% - 12%
* Pharmacological and Parenteral Therapies: 13% - 19%
* Reduction of Risk Potential: 13% - 19%
* Physiological Adaptation: 11% - 17%

Now that you know the basic percentages that each topic consumes within the test plan, you can judge how to portion your time for test study. For instance, if you're weak in "Safety and Infection Control," you know that you risk blowing from 13% to 19% of that test if you don't study that subcategory. If you read further into the PDF file offered by the NCSBN, you'll discover that there are thirteen topics listed within that "Safety and Infection Control" subcategory:

1. Accident Prevention
2. Disaster Planning
3. Emergency Response Plan
4. Error Prevention
5. Handling Hazardous and Infectious Materials
6. Home Safety
7. Injury Prevention
8. Medical and Surgical Asepsis
9. Reporting of Incident/Event/Irregular Occurrence/Variance
10. Safe Use of Equipment
11. Security Plan
12. Standard/Transmission-Based/Other Precautions
13. Use of Restraints/Safety Devices

The NCSBN warns that the topics above are included in the "Safety and Infection Control" subcategory, but they may not be limited to those thirteen topics. Still, these topics can provide you with guidance in how to study for that subcategory. If you know these topics, then you can bring that 13% to 19% of the test plan score up to par and you won't fail that section.

After you preview what's expected from you for both tests from that PDF, you'll want to visit the NCSBN Learning Extension, where you can find various tips, courses, and reviews for the test plans. Not all the information on this site is free, but you are free to make the choice between paying for materials here or - with the test subjects under your belt - use free online materials to study for the exams. Another resource is the NCSBN PDF file, "Candidate Bulletin" for 2007, which outlines every question you might have about these exams.
About Registering (or Re-registering)

A 365-day time period during which a board of nursing may determine the candidate's eligibility begins when the board of nursing receives the candidate's registration from the test service. Once a candidate is made eligible, he or she must test within the validity dates printed on the Authorization to Test (ATT).

If a candidate's board of nursing is unable to make that candidate eligible within the 365-day time period, the candidate must wait until his or her current registration expires before re-registering. If a candidate re-registers before a current registration expires, the second registration will be processed and denied and the fee collected for the application will be non-refundable. Additionally, candidates who are not made eligible by their board of nursing within 365 days will forfeit registration, including the fee. Candidates then must re-register and re-pay the examination fee.

As a candidate, you can register online at Pearson VUE (www.pearsonvue.com/nclex), by mail (see instructions at https://www.ncsbn.org/1202.htm), or by phone (instructions also at https://www.ncsbn.org/1202.htm). The fee for taking the NCLEX examination currently is $200. Candidates may also have to pay other fees for licensure required by the board of nursing in the application jurisdiction. There will be no refund of registration fees (mail, telephone, or via the Internet) for any reason. This policy also applies to the current international scheduling fee of $150.

If you apply by Internet or if you supply an email address, you will receive information from Pearson VUE by email. If, however, you don't provide an email address for communications, all correspondence from Pearson VUE will arrive only through U.S. mail.
NCLEX Test Time

The current NCLEX examination is a four-option, multiple-choice examination that includes "alternate items" [PDF]. Alternate items will allow candidates to demonstrate their entry-level nursing competence in ways that are different from the standard multiple-choice items. Follow the link to learn more about these items so you'll be prepared for those questions.

The NCLEX multiple-choice exam uses an interactive system called Computerized Adaptive Testing (CAT) to gauge your level of competence. After you've answered the minimum number of questions (75 out of 265 questions for RN candidates, 85 out of 205 questions for LPN candidates), the computer will attempt to access your level of competence. The questions that follow may vary from that point for each candidate. To read more about how the CAT system works, take some time to review NCSBN's PowerPoint explanation about CAT.

At the point of minimum answers to questions, you can basically determine if you will pass or fail. If you are clearly above the passing standard at the minimum questions, you'll pass. If you are clearly below the standard, you'll probably fail. If you fall too close to the standard to allow a definitive result, you'll continue to answer questions until a final assessment can be determined. Read more about how the answers to the questions are determined at NCSBN's FAQ.

You have five hours to complete the exam, and this time includes the introductory computer tutorial and two ten-minute breaks. The NCLEX examination is scored once by the computer on which you take the test, and a second time by the National Council's testing service. It will take about a month for your state board of nursing to send the results of your exam to you.

If you fail the test, it's not the end of the world. In fact, you're somewhat at an advantage if you need to retake the exam, as your state board of nursing will mail a diagnostic profile to you that outlines both the areas of knowledge where you performed well and areas where you performed poorly. You can retake the test as many times as you need to pass. The National Council's policy dictates that you wait at least 91 days before retaking the test, but individual state boards may impose other requirements. Check with your state board to learn about your local restrictions.
Testing Tools

You can find many online tools that are designed for both the NCLEX-RN and the NCLEX -PN. Some companies offer their materials for a fee. Some of these companies, listed in alphabetical order, include:

* InternetExam Online Practice Exams
* Kaplan Nursing
* Measure Up
* NCLEX Excel
* NCLEX-Practice
* Peterson's
* Test Prep Research
* Thomsen Delmar Learning

You can also purchase review books and sample tests in book form, such as the books at InformIT, eBookMall, and Amazon (do search for NCLEX). And, you can also take NCLEX prep courses in a traditional classroom setting through the following companies:

* Kaplan
* NCLEX Excel
* Nursing Education Consultants
* Rineheart and Associates

You may not be able to afford all the help offered above, but you can find resources online for free including a Google book search for NCLEX (beware of outdated documents for many topics). Other sites you might peruse include the following:

* 4Tests
* Caring4You
* Delmar's Online NCLEX Review
* Exam Cram
* NCLEX & HESI Online Course
* NCLEX Course Review
* Nursing Study
* Study Guide Zone

Test Preparation

Now that you know most of the basics about the NCLEX, we want to pass on some tips about how you can prepare for this test. If you took the SAT or ACT in high school, you may soon realize that the NCLEX isn't much different in its style (or in its pressure or stress!). The major difference is that the NCLEX is necessary for you to pursue a nursing career. With that said, you can take the pressure off a bit by reminding yourself that you can retake this test if you fail.

To increase your odds for success, you need to plan ahead. Here are some tips that may help you pass the test with ease:

1. Learn How to Learn: Before you begin to cram for these exams, read the tips listed at OEDb's article about memory and learning. There are 75 tips listed here, but they're all sorted into categories that you can tackle easily. For instance, you'll need to set aside a place at home where you can study quietly, and you'll need to know whether you truly need flashcards to learn or not. You might not be a visual learner!
2. Practice Testing: Tests often make people very nervous, and this is a huge source of stress. To help eliminate some of this stress, try to simulate a testing atmosphere at home. Use the resources listed below to develop tests, and spend a good hour taking the test in a quiet atmosphere without a break. You'll develop endurance, and you'll also learn your weaknesses as well as your strengths with these 'tests.' Practice with online testing, as this exercise will reduce stress over taking the test online during the actual exam.
3. Get Plenty of Rest: Sleep is one cure to stress, and sleep will also help you to improve your memory. If at all possible, try to get a good night's rest not just the night before the exam, but for the entire week prior to the exam.
4. Take a Deep Breathe and Read Each Test Question Slowly: One way to understand a question on the test is to rephrase it. This way you can pick out all the verbs, nouns, and any other grammatical directives that will turn a 'trick' question into a reasonable query.
5. Be Confident: Fear is a big stress factor. But, if you've learned your material and you know it (not just memorized it), then why worry? Your confidence in what you know will help you to ride through this stressful exam. If you pass, then that score will validate your confidence. If you fail, then you have all the tools at your fingertips to try the test again. Just because you fail the exam does not mean that you are a weak, bad, or otherwise worthless individual.

If you heed the tips listed above and the all the material listed at NCSBN, you may end up enjoying the whole testing process. Good luck!


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