10 DO’S AND DON’TS TO HELP YOU PASS THE NCLEX EXAM THE FIRST TIME

DO’S ON HOW-TO PASS THE NCLEX EXAM THE FIRST TIME

Learning how-to pass the NCLEX exam is a crucial milestone for nursing school graduates. I know how nerve-wracking it is to prepare for the biggest exam of your life—I put together a list of 10 simple Do’s to follow to help you pass on your first try.

1. Know Your Learning Style

We all have different learning styles i.e. visual, reading/writing, kinesthetic, auditory, or a combination of all. Once you identify how you learn best, utilize it to help you prepare for the NCLEX exam. This will give you more “bang for your buck” so to say, allowing you to learn easily and retain the information you need for the nursing exam.

Learning Style Examples:
• Visual: Color code your notes or use a whiteboard to write out simplified notes/diagrams
• Auditory: Listen to YouTube videos or recorded lectures if you're allowed to record
• Reading/writing: Read a study guide or write out your own guide with high-yield information
• Kinesthetic: Use a whiteboard to write/draw

2. Review the NCLEX Exam's Format

As of 2022, on both versions of the NCLEX exam, you will see 75 to 265 items chosen from a question bank. These questions also include 15 pre-test items that are not scored. Scoring is based on a “computerized adaptive testing” formula that progressively chooses more challenging questions as you progress through the exam.

Currently, there are 6 types of questions you might see on the exam:
• Multiple choice
• Multiple select all that apply
• Ordered response (drag/drop in order)
• Fill in the blank
• Hot spot
• Chart/exhibit

The look of the NCLEX exam isn’t homogenized throughout the entire exam. Some items will be presented as short scenarios and a question following. Along with a minimum of 3 situations in the form of a case study with six questions.

3. Know and Apply ABCs and Maslow's Hierarchy During the NCLEX Exam

Both the ABCs and Maslow’s Hierarchy are ways of prioritizing the most pressing issue for the patient. Using these theories will help you answer the questions that ask you what you should do first, or what is the most urgent matter at hand. Keep in mind that sometimes you will need to use both the ABCs and Maslow’s Hierarchy to come to the correct answer– so be sure to know how to apply both.

• The ABCs are used for the prioritization of actions. “A” or airways being the most important, then B for Breathing, followed by C for Circulation.
• Know all the levels of the pyramid of Maslow’s Hierarchy.
• Ask yourself, which need is the most important to address first based on Maslow’s Hierarchy?
• Remember psychological needs are the most important (breathing, food, water, sleep, etc.)

4. Understand the Difference Between the Real World and the NCLEX

While we would love it if the real world was as by the books as the NCLEX exam, it’s never that straightforward. It’s important to understand where the two differ. Sometimes what you actually do at work will lead you to answer the question wrong– we know it’s confusing. The NCLEX is based on the ideal world, not what we actually experience.

• Remember the NCLEX exam = “Perfect” hospital– meaning no staffing shortage, you only have one patient, no time constraints, endless supplies and tools at your disposal, etc. (unlike real life)
• Answer the questions on the exam based on the “perfect hospital” not what you really do at work.

5. Get Plenty of Rest

The importance of sleep is often overlooked while preparing for the nursing exam. However, it’s vital to get ample amounts of rest not only the night before the exam but throughout the months of preparing for the exam. When you’re sleeping your body is storing the information that you’ve taken in so that you can retain it long-term. If you don’t get enough sleep you won’t be able to recall the information when you need it most on exam day.

• Get enough sleep during your study periods and the day before your NCLEX exam
• Before each study session, ensure you have gotten adequate sleep and start off with a fresh mind
• Cramming and depriving yourself of sleep is not an efficient way to study and you won’t be able to retain as much

6. Focus on the Areas You Struggle with First

As you know, there’s a lot to cover for a nursing exam. If you leave yourself unchecked chances are you will gravitate toward the areas that you like or feel good about– however, when you’re preparing for the NCLEX exam it’s a sound strategy to give more importance to the areas you struggle with. Try to list the areas that you feel confident with, then a list of the areas that you’re not as confident in. Always start your study session out by reviewing the areas you don’t feel as strong in. It’s a lot easier to keep your motivation up at the end of the day if you’ve already gone over the tough stuff.

• Make a list of the concepts you feel good about and the ones you need to work on
• Start every study session with the concepts that you struggle with
• You can Identify the concepts you struggle with by trying to teach someone else. If you refer to your notes/books then it needs work.
• Ex: If you struggle with maternity/pediatrics, review your notes and do practice questions until you feel confident to teach them to someone else

7. "Think Like a Nurse"

“Think like a Nurse” is a phrase every nursing student has heard at one point or another– but what does it mean in the context of the NCLEX exam? While it speaks to the intuition that aids judgment calls that come with being an experienced nurse, you can start thinking like a nurse while you’re still working on becoming a registered nurse.

• Thinking like a nurse comes with time and experience, so be patient with yourself
• Using a mixture of critical thinking (ex. Using ABCs or Maslow's Hierarchy for prioritizing) and clinical judgment to make decisions.

8. Learn and Practice Select All That Apply Questions

Some of the trickiest questions on the NCLEX exam are the “Select All That Apply Questions.” Luckily there are plenty of resources available to practice. One of the best strategies for tackling these questions is approaching each answer as a “true or false statement.” By breaking it down the question is a lot less intimidating and allows you to focus on each answer individually.

• Seek out the resources to practice “Select all that apply” (SATA) questions.
• Try breaking down the question and viewing each option as “true or false” statements.
• It's also important to read and understand the rationales, this will help guide you to correctly answer other NCLEX-style questions

9. Know and Apply Prioritization

In nursing one of the most important skills is the ability to prioritize. This is tested time and time again in the NCLEX exam. One tactic that is proven to work is for each question to ask yourself, “Which patient would have the most harm/die if I don’t see them or do xyz for them?”

Example NCLEX exam question that requires this logic: The nurse receives the shift report from a nurse on the prior shift. The nurse must see all four patients, but who would the nurse see first?

• 1. A patient who has an order for a urine culture to be sent to the lab
• 2. A patient with an oxygen saturation of 92% with a history of COPD
• 3. A patient who is complaining of dyspnea after completing an albuterol nebulizer treatment
• 4. A patient who is threatening to leave against medical advice if a doctor doesn’t see them right now

Hint: Look out for keywords indicating prioritization: First, Most important, Initial

Now you can rule out situations that are expected or chronic:

• A urine culture is important to rule out infections, but this can wait until the nurse sees the other patients.
• Don’t let them trick you into thinking an O2 sat of 92% is a priority. Remember with patients with COPD, their baseline O2 can be 90-93%, so this is expected.
• This patient is complaining of dyspnea (difficulty breathing), which is a concern (remember ABCs), especially since they just completed an albuterol neb treatment.
• A patient threatening to leave AMA must be seen by a nurse and provider to discuss the risks of leaving, but this can also wait until the other patient is seen.

The correct answer is 3. A patient who is complaining of dyspnea after completing an albuterol nebulizer treatment
Reasoning: If the nurse does not see this patient first, it might result in harm to the patient or even death.

10. Schedule Breaks Into Your Study Schedule

The last thing you want during your nursing exam preparation is to burn out. It’s tempting to burn the oil at both ends but this could lead you down a slippery slope that doesn’t end well, so make sure to schedule breaks into your study schedule. Create a study schedule for yourself that includes rest periods. It doesn’t have to be a huge break, using the Pomodoro method is an effective way to manage your time– it accounts for 60 minutes of focus and then a 10-minute break.

• Create a study schedule, and incorporate breaks/rest in between sessions
• Burning out is the last thing that you want to do while studying for your exam
• Many find the Pomodoro method useful: Study for 1 hr, break 10 min, study 1 hr, break 10 min, etc. You can set a timer on your phone, or computer, use an app, or a physical timer.

10 DON’TS OF PASSING THE NCLEX EXAM THE FIRST TIME

Now that you know the Do’s, there are a few more strategies to help you achieve your goal of passing. The following is a list of 10 Don’ts to avoid to help increase your chance of passing the NCLEX exam the first time.

1. Don’t Cram Days or Nights Before the Exam

It’s proven that the best way to retain information is to study in small increments constantly over a longer period of time. Plus, when you cram you don’t get the rest that you need in order to have a fresh mind on the day of the NCLEX exam, which you absolutely will need.

2. Don’t Rely on Past Work or Clinical Experiences

As mentioned earlier in the article, your work or clinical experience doesn’t always translate well onto the NCLEX exam. The exam is based on what would happen in a perfect hospital and we know that in the real world it’s not always realistic. Rather, focus on asking yourself in the ideal world where I have everything I need, how would I handle this situation? This will help you get away from your real-life work experience and into the mindset of the NCLEX.

Don’t Overwhelm Yourself with an Abundance of Resources

There are a lot of resources out there to help you prepare for the NCLEX, which is great, however, it can be counterproductive to overwhelm yourself with everything. Find 1 or 2 resources that work with your learning style and master those before adding any additional resources to your study regime. I found UWorld and Nurse Barbara’s NCLEX Study Guide to be extremely helpful.

4. Don't Wait Too Long to Take Your Exam

While you might think waiting longer to take your exam gives you more time to study, it’s better to take the NCLEX exam as soon as possible. It’s recommended within the first 1-2 months of graduating. You want to take it while the content is still fresh in your mind and before you get too into the mindset of a real hospital.

5. Don’t Rush to Answer the Questions

Even if the question seems like a no-brainer, take your time on each question. Don’t rush through a question, automatically assuming you know the answer. This style of Nursing Exam is testing more than just your knowledge. It tests your critical thinking and reasoning skills, along with your ability to make judgment calls. If you try to speed through a question it’s likely that you’ll miss some vital information that could lead you to get the answer wrong.

6. Don’t Expect Your Exam Questions to be the Same as Other Exams

The NCLEX exam is adaptive. Meaning that it’s designed to change based on your answers. It identifies which areas you’ve got down, and which you’re struggling with. This means you can’t completely rely on what someone who’s taken the test before tells you is on it. Rather you need to study all the relevant material, take multiple practice exams and of course, give it you all!

7. Don’t Second-Guess Yourself

Self-doubt is the achilles tendon of all test-takers. It’s easy to sway yourself, especially when you’re answering a question that is on a topic you're not 100% confident about. Once you’ve decided on your answer, using all the reasoning, logic and knowledge that you’ve been practicing, stick with it. Trust your instincts and your preparation.

8. Do Not Focus on the Number of Questions You Receive on the Test

While taking the NCLEX exam, you can get anywhere between 75-265 questions. However, the amount of questions you are presented with should not be your focus on exam day. Don’t try to read into what it means to have a lesser or greater amount of questions, rather just focus on answering each and every question individually.

9. Don't Study the Day Before Your Exam

The day before the exam you should already be fully prepared to take the exam– so rather than stressing about getting one more study session in, use the day to relax. Allow yourself to get a good nights rest and trust that all of the hard work you’ve put in the weeks leading up to this are all going to pay off.

10. Do Not Give Up!

Don’t fret if you don’t pass the NCLEX exam the first time around. The exam is tough, so rest assured that plenty of great nurses had to take the exam multiple times before passing. The most important thing is to not get down on yourself if you don’t have the results you were hoping for, and of course not to give up!