How To Answer NCLEX-Style Questions

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December 2012


A lot of students struggle in nursing school or fail the NCLEX board exam because they don't understand how to approach NCLEX-style questions. I want to share these tips so that you can escape that fate.

3 SimpleTips for Success


Tip #1: Move Linearly Through The Nursing Process 


NCLEX-style questions require moving linearly through the steps of the nursing process: Assessment, Nursing Diagnosis, Planning, Implementation, Evaluation. The first step to address a new non-emergent problem is to collect data. After collecting data, the nurse then analyzes that data in the Nursing Diagnosis step and then formulates nursing diagnoses. Remember, actual nursing diagnoses must have three parts: the NANDA-approved nursing diagnosis, the etiology, and the signs of symptoms. For example, impaired gas exchange related to acute asthma exacerbation as manifested by 02 sat of 89% on room air, bilateral wheezing, tachypnea, and supraclavicular retractions.

At the Planning step, the nurse sets goals for the patient. Remember that goals must be measurable and have an associated timeframe. Implementation involves directly providing care to the patient, and the effectiveness of any intervention must then be evaluated. A nurse who administers an as needed pain medication because her assessment revealed the patient complaining of a pain level of 5/10 must then evaluate the effectiveness of the medication an hour later by again asking the patient to rate their pain level. The best way to evaluate the teaching of psychomotor skills is to watch the patient or designee perform a return demonstration. These types of questions often pop up in the form of teaching an unlicensed medical personnel how to use a glucometer or teaching a client to self-administer insulin or use an inhaler for asthma. The best way to know that teaching was effective is to directly watch the student correctly perform the task. And after evaluation the cycle begins again with assessment.

Tip #2: Look For Clue Words


There are certain clue words that signify that there is a serious issue that makes the question a prioritization question. The words first, initial, priority, and "most important" are critical to recognize. Priority interventions focus on safety, security, and basic physiologic needs (think airway, breathing, circulation). In non-emergent situations students should strictly follow the nursing process, but in a priority-style question the nurse's first action may be an intervention. For example, for a patient actively bleeding (active bleeding is the highest priority patient) the nurse's first action is to apply direct pressure, not to assess heart rate and blood pressure. The reason is that just the fact that we are told the patient is bleeding is enough of an assessment to merit immediate intervention. The highest priority patients are those who are actively bleeding, in respiratory distress, or circulatory collapse because ultimately what kills someone is a lack of oxygenated blood. It is also critical that students recognize that tachycardia, tachypnea, and hypotension indicate shock. 


Tip #3: Identify Prefixes and Suffixes 


Students often run into questions that they don't know the answer to off the top of their head and so they quickly offer a guess and move on. That's bad test taking. Prefixes and suffixes can often give away the answer. For example, I recently had a client miss the following question, "A patient is suspected of having amyotrophic lateral sclerosis. What diagnostic test does the nurse anticipate the physician will order?" My client selected angiography. The correct answer was an electromyogram.

Myo means muscle. Knowing that prefix at least reveals what organ system we're talking about. Similarly, angio means blood vessel. And even if those prefixes don't ring a bell from Anatomy & Physiology, myo was in the name of the disorder and in the correct answer. All things being equal, select the answer that shares a root word with the condition. Even just matching the answer with myo in it with the condition with myo in it would have yielded the correct answer.

So those are three tips to help you on NCLEX-style questions. Students looking for more help are welcome to contact me for personal tutoring or are welcome to come attend my 4-Hour NCLEX Prep Class on January 6th from 12:30 PM - 4:30 PM in Woburn for only $50. I hope to see you soon, and I hope you have a great holiday and a very happy new year!

Best Wishes,

Daniel A. Clinton, RN, BSN
NCLEX Specialist


About The Author
Dan Clinton is a Registered Nurse, CPR and First Aid Instructor, Professional Anatomy, Physiology, Nursing, and NCLEX-RN tutor, Researcher, Writer, Entrepreneur, and overall swell guy. Dan channels his passion for helping others through his businesses, striving to fulfill the American dream of succeeding through altruism, hard work, persistence, and ingenuity. As a CPR and First Aid Instructor, he offers comprehensive and cutting-edge American Heart Association CPR and First Aid instruction throughout Massachusetts and the New England area. As a professional tutor, Dan holistically aids his clients reach (and often exceed) their goals, and he has quickly developed a reputation as Boston's premier tutor for the nursing board exam (the NCLEX-RN).
Dan lives in Salem, Massachusetts, works way too hard, hopes to someday finish his first book which will show how to fix the fractured American healthcare system and teach its readers everything they need to know to dramatically improve their health, and he has never outgrown singing along to Disney songs.