Levels of NCLEX-RN examination
NCLEX-RN (National Council Licensure Examination-Registered Nurse). All boards of nursing in states and territories of the United States require candidates to pass this exam for licensure as a registered nurse (RN). The NCLEX-RN uses the five-step nursing process. Each of the questions will fall into one of the five steps: assessment, analysis, planning, intervention and implementation, and evaluation.
NCLEX-RN Exam content:
The NCLEX-RN exam‘s content is based on client needs: Safe and Effective Care Environment Management of Care 17-23% Safety and Infection Control 9-15% Health Promotion and Maintenance 6-12% Psychosocial Integrity 6-12% Physiological Integrity Basic Care and Comfort 6-12% Pharmacological and Parenteral Therapies Reduction of Risk Potential 9-15% Physiological Adaptation 11-17%.
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The Physiological Integrity category contains the majority of the questions on the exam, about 43-67 percent. This portion of the NCLEX deals with adult medical and surgical care, pediatrics, and gerontology, which is the study of the elderly and the effects of aging. Some of the and infectious diseases could be asked. There are different topics on the NCLEX pertaining to the pediatric client. These topics may include growth and development, birth abnormalities, child abuse, common infectious diseases of children, and usual childhood traumas such as burn injuries and fractures.
Safe and Effective Care Environment
This category makes up approximately 21-33 percent of the NCLEX questions. Questions in this category cover safety issues in patient care, particularly the administration of medicine to patients, safety measures to prevent further injuries and infections, isolation precautions, safety for pediatric patients, and special safety precautions for patients with psychiatric problems.
This portion of the exam may also include questions pertaining to laboratory tests, test results, and unique nursing procedures that may be associated with test results; ethical and legal nursing problems; nursing management; and issues related to giving patients the best care. NCLEX questions on these topics are randomly spread throughout the exam.
Health Promotion and Maintenance
The Health Promotion and Maintenance category makes up about 12 percent of the NCLEX examination. Questions under this category deal with birth control measures, pregnancy, labor and delivery; care for a newborn infant, growth and development, and diseases that can spread easily like sexually transmitted infections. If a patient is pregnant, it is very important that the nurse be able to act as a teacher or counselor for the patient. This makes it necessary to understand all components of a patient’s pregnancy. Knowledge of a proper diet, development of the fetus, signs and symptoms of pregnancy complications and certain pregnancy related procedures will be helpful for this section of the exam.
Like the section on Health Promotion and Maintenance, the Psychosocial Integrity category constitutes approximately 12 percent of the NCLEX questions. Questions in this category pertain to patients with psychiatric problems and their unique issues. In addition, this material may cover coping mechanisms for different situations. Other situations covered in this section are about psychosocial problems that fall short of psychiatric illness. Questions could cover information on the following disorders: depression, schizophrenia, organic mental disorders, eating disorders, personality disorders, and anxiety disorders. Also included in this section may be questions about crisis intervention, substance abuse, and therapy through communication.
NCLEX-RN exam question types:
Most of the questions of the NCLEX exam are worded multiple choice questions. In recent years, however, the NCSBN has added new format questions which do not involve simple multiple choice selection. Examples of the new formats include identifying and selecting a particular area of a drawn body part; selecting multiple correct answers via check boxes; free response mathematical questions usually involving medication calculations; and ordering the steps of a medical or nursing procedure.
Questions on the NCLEX exam are of three different types or levels: Level 1, Level 2, and Level 3. Level 1 questions are the most basic questions and make up less than 10 percent of the total questions. Level 1 questions test the individual’s knowledge and understanding. These questions require the individual to recall specific facts and information. Level 2 questions require an additional level of thinking in order to answer the question. In these types of questions, the individual will be required to know specific information and then use it to interpret or analyze the question. Level 2 questions are analysis and application type questions. Level 3 questions are the most complex type of question on the NCLEX. These questions require the individual to judge, evaluate, and combine information. The individual will have to apply the rules, facts, and processes they know and then make decisions about what is best for the patient’s care based on the situation. What makes level 3 questions difficult is the likely existence of more than one correct answer forcing the individual to decide which answer is the best choice. Level 2 and Level 3 questions make up about 95 percent of the questions on the NCLEX exam. However, it is possible for the exam to have no Level 1 question.
NCLEX-RN Exam Format
The NCLEX exam is taken on a computer at a Pearson Professional Center. Pearson Professional Centers are testing centers for certifications and licenses all over the world. There are numerous testing centers in each state of the U.S. and centers can be found in 175 countries. The NCLEX exam is at least 90 percent multiple-choice questions. The remaining questions require an individual to fill in the blank, choose all of the correct answers from a list of options, put a number of steps in the correct sequence, or identify a correct area on a picture. Some of these alternative format questions ask information about a chart, graph, or audio clip. The questions can also use pictures as the answer choices instead of words. Each question will appear one at a time on a computer screen. Questions will not be repeated; however, questions based on a similar situation could be asked.
Each individual will take a different form of the exam. Since each question depends on how the previous question is answered, an individual can be given between 75 and 265 questions. Only 60 out of the first 75 questions on the exam will count. The 15 that do not count are “trial” questions, and these will be used on future examinations. The “trial” questions are not identified as such, therefore, it is best to answer every question. If the individual continues to get questions from the same category, it could mean that the NCSBN is testing those types of questions, or it could mean that the individual keeps getting those types of questions incorrect. The computer will continue to randomly generate questions from that category until the individual has met the requirements of the test plan.
Each individual will have a maximum of six hours to complete the exam but there is no minimum time limit. There is a mandatory 10-minute break about 2 ½ hours after the start of the exam and another optional break after about 4 hours of testing. It is acceptable to take breaks any time during the exam, however, test-takers will lose the additional break time from the total test time.
A certain number of correctly answered questions is not required to pass the exam. An individual’ s score will not be compared to other scores to determine if he or she passes. The NCLEX is graded by comparing the responses to a pre-established standard. Those individuals who meet or exceed the standard pass the exam, those who do not fail.