Sometimes, it is not all about how high your academic ratings were in college and how much you have retained in nursing classes when you take board examinations. Mostly, it is about the strategies when taking a big exam that will define the course of your career. All it takes is a lot of practice with the many test strategies out there. This article highlights five smart strategies ( referred to as “STAPE”) when taking the NCLEX (National Council Licensure Examination). NCLEX is a board examination for nurses who need to be licensed to practice nursing in the United States and Canada since 1994 and 2015, respectively. Here are 5 strategies you can use to jump-start your career in nursing practice either in Canada or the US
1.S- Start on something now.
“The secret of getting started is breaking your complex overwhelming tasks into small manageable tasks, and then starting on the first one” – Mark Twain
This strategy is most applicable when preparing to take the NCLEX-RN. There will come a time when you begin to feel so overwhelmed that you do not know anymore where to begin and what to focus on. Start by getting familiar with the NCLEX-RN Test Plan. Not knowing what you are getting yourself into, adds to your anxiety which can only add up to your feeling of being overwhelmed. It helps a lot to know the format and general content of the NCLEX because this will help you come up with better strategies when taking the test and can help alleviate your anxiety.
Start by understanding the Test Plan Structure. The NCLEX-RN Test Plan is organized into four major Client Needs Categories: Safe and Effective Care Environment, Health Promotion and Maintenance, Psychosocial Integrity, and Physiological Integrity. The Safe and Effective Care Environment category is divided into 2 subcategories: Management of Care, and Safety and Infection Control. The Physiological Integrity category is divided into 4 subcategories: Basic Care and Comfort, Pharmacological and Parenteral Therapies, Reduction of Risk Potential, and Physiological Adaptation. More elaboration of this Test Plan Structure is found in this blog article, “Step One: Familiarizing the NCLEX-RN Test Plan.”
2. T – remember Textbook, not real world.
When taking the NCLEX, read and understand the situation and the question as best as you can. When choosing from the options, choose the most ideal option that appropriately answers the question. Eliminate the options that seem realistic but not ideal. Most of the time, all the options are correct but only one will best answer the question. Remember to choose the universal standards; the most patient-centered approach; the nursing care measures over the medical measures; and the most therapeutic communication or approach.
3. A- Avoid “Absolutes”.
When looking for the best answer, examine the options’ statements. When you find absolute words such as always, all, never, everything, everyone, none, only, must, every time, and every, take this as a clue that the option may be a distractor. Distractors are usually incorrect options.
A nurse is providing discharge instruction to the mother of a 3-year-old child with hemophilia and tells the mother to do which of the following to promote a safe environment for the child at home?
- Remove toys with sharp edges from the child’s toy box.
- Allow the child to play with toys only if a parent is present.
- Place a helmet and elbow pads on the child every day.
- Allow the child to play indoors only.
Test-Taking Strategy: Avoid options that has absolute words. Options B and D contain the absolute word, ONLY. Option C contains the absolute word, EVERY. This leaves you with option A. Remember that absolute words usually tend to make an option incorrect. Avoid absolutes
4. P – Prioritize the top task.
Prioritize what is asked for in the situation. When the question contains the keywords initial, first, priority, or best, it is usually assessing your prioritizing skills. How good are you at prioritizing nursing actions? How good are you at prioritizing patient’s needs? The options you will be considering are usually all correct but there should only be one nursing action that must be done first or there should be only one top priority. How then do you prioritize?
You can use the ABCs technique, Maslow’s hierarchy of needs, or the nursing process.
ABC – means Airway, Breathing, and Circulation. Identify what the question is asking for. Next, examine the options. Is there an option that talks about a patient with an airway problem? Is there an option that contains an intervention that is associated with providing airway management? If yes, then this is considered top priority.
Maslow’s Hierarchy of Needs– Does the situation or case scenario describe a patient or patients with multiple problems to be addressed? If this is the case, then the Maslow’s Hierarchy of Needs where the physiologic needs such as air, water, food, diet, nutrition, sleep, pain management are prioritized more than safety and security needs. Safety and security needs are also prioritized more than psychosocial needs of the patient or patients.
Nursing Process– This refers to assessment, diagnosis, planning, intervention, and evaluation as steps in the nursing process that can be used as prioritization technique. Read carefully the question. What is being asked? Is there a need to assess first or was assessment already done and now you need to choose the next action and the best option after assessment? Follow the sequence when prioritizing. Planning should be done after assessment and before performing the intervention. You can also ask yourself if there is a need for you to collect more assessment data on the patient before performing an intervention or even calling the physician.
5. E- Eliminate the “inappropriates.”
Use the “Elimination” technique. Options that are obviously incorrect and do not address the situation or the question should be eliminated. This process most often will narrow down your choices to two out of the four options. When you are left with two options, you need to read the question again and the remaining two options. Remember, time is running and you do not need to spend too much time deciding which one is the best option. Follow these simple steps when you try to decide which one between the two remaining options you should choose as the appropriate answer.
- Focus on the case event.
- Identify the question query.
- Look for strategic or key words.
- Ask yourself, “What is the question asking?”
- Read the two remaining options again.
- Use your nursing knowledge, prioritization techniques, avoid absolutes or choose the most “textbook” or ideal and most therapeutic, patient-centered, most compassionate and humanistic answer.
- Finally decide & stick to that answer.
This elimination technique requires practice and you will only master this when you answer hundreds of NCLEX questions.
If you want to pass NCLEX-RN, you have got to master the test taking strategies. There are so many strategies out there but these top 5 strategies are easier to recall and apply. Remember STAPE: start on something now, “textbook, not real world,” avoid absolutes, prioritize the top priority, and eliminate inappropriate options.
NCLEX Test Taking Strategy. (2008). Retrieved from testtakingstrategies-nclex.blogspot.com: http://testtakingstrategies-nclex.blogspot.com/2008/12/eliminate-options-that-contain-absolute.html
NCSBN. (2016). NCLEX-RN Examination: Test Plan for the National Council Licensure Examination for Registered Nurses. Retrieved from ncsbn.org: https://www.ncsbn.org/RN_Test_Plan_2016_Final.pdf
Nurse Journal. (2016). How to Master NCLEX-Style Test Questions. Retrieved from nursejournal.org: http://nursejournal.org/community/master-nclex-style-test-questions/
Test-Taking Strategies. (n.d.). Retrieved from stkate.edu: https://www.stkate.edu/pdfs/test-taking-strategies.pdf
Test-Taking Tips for NCLEX. (n.d.). Retrieved from jdcc.edu: http://www.jdcc.edu/includes/download.php?action=2854&download_file_id=4176&action=2854&table_num=
The University of Arizona College of Nursing. (n.d.). Test Taking Strategies Workshop. Retrieved from nursing.arizona.edu: https://www.nursing.arizona.edu/sites/default/files/uploads/test_taking_strategies.ppt
Ultimate Guide: 60 NCLEX Strategies to Use in Answering Questions. (2015). Retrieved from brilliantnurse.com: https://brilliantnurse.com/nclex-strategies/