NCLEX-RN®: The Exam

by Rhonda Lawes, PhD, RN

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    00:00 Let's talk about some of the steps you have to take before the exam.

    00:04 The NCLEX registration process has multiple steps, and there are a lot of people that are involved in it. So it's going to take some extra time for you to make sure that you have every box checked like you're supposed to.

    00:16 Now, some schools will hold your hand all the way through the process and they'll walk you through it. I know at the university I teach at, we actually have a special class and we sit them down, sign them on to their state board site and walk them through the process. But let's talk about what that entails.

    00:32 First, you won't be able to schedule your NCLEX until you have an authorization to test Okay.

    00:38 At is what you'll hear people call it, but you won't be able to schedule a time to take the NCLEX until you have your authorization to test.

    00:46 People are usually really nervous.

    00:47 They want to take the NCLEX as soon as possible or they don't want it to anyway.

    00:51 It does not matter when you want to take the NCLEX until you get your authorization to test. So let's talk about what you need to do to make sure you get that in a sufficient manner as possible.

    01:03 How this works is you graduate from an accredited nursing program.

    01:07 Your school verifies that you've met all the requirements.

    01:10 There's not any holes on your transcript, and then they send that notice to the Board of Nursing.

    01:15 Meanwhile, you had to apply separately to your board of Nursing.

    01:20 So every board of nursing has a little bit different process.

    01:23 You can find that information on their website, so you make sure you do everything you need to do in your nursing school.

    01:29 You also apply to your state board of Nursing and they'll be special things you need to do, maybe fingerprint checking, security checks, whatever they require you to do. There's usually a certain time frame when you have to get it done close to the time when you apply.

    01:44 So make sure you read the fine print carefully.

    01:48 So take care of everything at school.

    01:50 They will pass your records on once it goes from your school to your state board of nursing. Your state board of nursing gets your records, looks at your application, makes sure everything is in order.

    02:01 Then they will notify Pearson Vue that you are approved to test and you are authorized to test Pearson.

    02:08 Vue will send you an act in your email.

    02:11 Here's the deal. That's another step for you.

    02:14 So one is make sure your school records are in order to make sure you have applied to your nursing regulatory body, your State Board of Nursing and three register with Pearson Vue. And they're going to want cash each one of these steps.

    02:29 So plan ahead.

    02:30 I always have students in their fourth semester plan a budget.

    02:34 They recognize how much it's going to cost, how much they have to pay.

    02:37 Pearson Vue, their State board of nursing, all the costs so they can take the budget.

    02:41 I usually recommend to students put it on your graduation cards.

    02:45 If you're planning on getting me a gift, I'd love some help with my NCLEX exam.

    02:49 I don't think that's tacky.

    02:50 I would love to get that from a student.

    02:52 Like, thank you.

    02:53 Now I know exactly what to get you.

    02:56 You want to start this process early, make sure that you have walked through it.

    02:59 You've got all your steps in order.

    03:02 I can't tell you how many times I've taught an NCLEX exam and people haven't even started this process. That's going to make a much longer time gap before you can sit for the exam. Now, let's talk about exam day.

    03:14 What are the things that you should expect? I also recommend if you have children, you know what you should do the day before your NCLEX ditch them if you can possibly in any way have someone else be responsible for your kids the night before your exam.

    03:30 That way you don't have to worry about a child getting sick or you being worried.

    03:34 Make sure you can release as much responsibility as possible.

    03:38 Not everybody can be night before the exam, so you can try and get the best night's rest possible. On exam day.

    03:46 We're going to talk about the What.

    03:48 You have to go through what the processes are and what the rules are.

    03:51 Now you want to check your site and make sure you have an acceptable ID, so you shouldn't have to bring your art, but you do have to have an acceptable ID and those will be listed on the site.

    04:02 Things that might qualify would be like a passport, a driver's license, but they're likely going to want more than one piece of ID, so make sure you address that.

    04:11 Let's talk about dressing comfortably.

    04:13 This is really important.

    04:15 Not the day to wear new shoes or things that pinch or or scratchy.

    04:19 You want things that you feel very comfortable in.

    04:22 You're not going to be able to take much into the testing room.

    04:25 So hats, scarves, gloves, coats, all that stuff is going to have to stay outside of the testing room and most likely in your locker.

    04:32 So don't count on being able to take any of those extra things in.

    04:37 You also can't wear a hoodie and put that up if you are cold natured.

    04:41 Dress in layers so that you can be warm enough.

    04:43 Nobody can think clearly if you're freezing cold and you can't count on what the temperature is going to be like in the testing room.

    04:50 So dress in layers so you can adjust by taking layers off or putting layers on.

    04:54 Now arrive 30 minutes before your exam.

    04:57 Okay. That's kind of important because they're going to seat people as they arrive according to their time.

    05:03 If you are late for an exam that really puts you in a bad spot.

    05:07 In fact, if you're 30 minutes late or more, you may have to forfeit, reregister and pay for another exam fee.

    05:13 And that is so expensive.

    05:15 So I always recommend to students the night before, at the very latest drive to the testing center, park your car, get out, walk to where the door is so you know exactly where you're going on test day and then leave extra early, you know, go get a cup of coffee or something before the test if you're there super early, but count on traffic being a hassle.

    05:37 Count on there being things that will slow you down and things you don't anticipate so that you're not late.

    05:43 And plus you don't want to walk into the test being really stressed out because you're late on where you got there.

    05:49 Once you're at the center, you're going to have to do things that prove you are you.

    05:54 So you do this when you initially enter to take the exam.

    05:57 And then any time you take a break and leave the testing room, you're going to have to go all through that process again.

    06:03 There's a pretty good reason people have tried before and other standardized tests to start a test, then go take a break and have somebody else come in and take their standardized test.

    06:12 That's why you're going to have your biometrics will be required upon entry to that testing room.

    06:18 You're also going to have to have a signature, a photograph, a palm vein scan in order to get your testing materials.

    06:24 You won't be allowed to bring any paper or any writing instruments in there.

    06:29 You're going to have an on screen calculator if you need it, and a write on wipe off board and marker will be given to you when you enter.

    06:35 If you fill that board up, they prefer that you not erase it.

    06:38 You just look into the monitor, raise your hand and let them know you need a new board.

    06:44 Now it's five hours total to complete the test, and this includes the short tutorial at the beginning and two optional pauses or breaks.

    06:53 What will come up on the screen will tell you you might want to take a break now.

    06:56 You can choose if you want to or don't want to.

    06:59 There's no forced breaks, but breaks do come out of your five hours.

    07:04 So I've had students take multiple breaks.

    07:06 I had one student take 1010 breaks during the test and they ended up having to go all the way to the end because it would take those breaks and just about have a fit in the bathroom about, I hate this, I don't want to do this.

    07:21 This test is horrible stories awful.

    07:23 She'd get done with that.

    07:24 She'd go back and then kept repeating that process over and over again.

    07:27 She passed.

    07:29 But wow, it was a very dramatic experience for her.

    07:33 Now you want to take your time and analyze each question, Know that some questions will be relatively fast, some will take a longer period of time.

    07:40 Here's what I want you to be aware of.

    07:43 If the time you're spending on this question seems to be long and you're not getting anywhere, you just find yourself saying, That's it, that's it.

    07:50 I'm the only one that's not going to pass the NCLEX I'm never going to make it.

    07:53 I don't know this question.

    07:55 You start finding yourself doing that.

    07:57 You're not making any forward progress.

    07:59 Pick an answer and move on.

    08:00 Absolutely. Pick an answer and move on and tell yourself it is one question.

    08:07 Okay. Just one question.

    08:09 Because if staying here and thinking about it more is going to freak you out, stop.

    08:13 Pick an answer. Tell yourself it's one question and just go on.

    08:17 So take your time, analyze questions, and use the strategies we're suggesting to you.

    08:22 But don't allow yourself to get paralyzed and stuck on one question.

    08:25 If reading it again is not helping, pick the answer and move on.

    08:30 Now, the exam itself is 85.

    08:32 Minimum questions up to 150 is the maximum questions and you have five hours to take that, including all your breaks.

    08:39 Now let's break that down a little bit more for you.

    08:41 52 of the items will come from the eight content areas that we talked about in those percentages that we posted for you.

    08:48 So 52 of the 85 items will come from those eight content areas.

    08:53 Now I'm giving you the examples.

    08:55 If you stop the test at 85, I don't recommend that be your goal.

    09:01 Because when I've seen students not be successful, it wasn't for lack of knowledge.

    09:05 It's because once they got to the minimum number and they kept going up, they started to panic. They started to sweat.

    09:10 They started having anxiety attack.

    09:12 You have to go in there saying, If I get 150, I get 150 questions.

    09:17 I'm up for it because I'm taking this test one time.

    09:21 But if you take if you get 85 and your test shuts off, 52 of those had to come from the eight content categories.

    09:28 18 additional items will come from the three clinical judgment case studies.

    09:33 Remember, the case study has six different questions in it about the same client.

    09:38 Now, the remaining 15 items, if you're doing the math with us, the remaining 15 items are unscored pretest items.

    09:44 This is What. Ncsbn does is they put questions in there and they see how students do on them. You will never know which ones are unscored this is them just running them through questions and students to make sure.

    09:58 Is this question a strong question in our students getting it right? Are they getting it wrong? Do we need to rewrite it? That's what those 15 unscored pretest items are.

    10:08 And remember, you don't know.

    10:10 So you just have to answer every question as if you thought it was one that counted.

    10:15 Now, the length of the exam is determined by how you've answered the questions.

    10:20 So the idea is when you answer a question, right, you kind of move up a little higher.

    10:24 And what you're trying to do is keep your average above the passing Standard That's the goal. That's why it's a computer adaptive exam.

    10:32 If you answer the question right, you move a little bit up.

    10:35 If you answer it right again, you move a little bit more up, you get a little harder question. If you get it wrong, you move down a little.

    10:41 If this is the passing Standard, your goal is you can miss questions as long as you keep yourself above that passing Standard and you will miss questions everyone does.

    10:52 Now, finally on exam day when you're finishing up, the test is going to end with a short survey that you are not going to be motivated to take because once you've made it through all that, the last thing you want to do is answer some more questions.

    11:04 Just collect yourself.

    11:06 Do your best, answer the survey questions and know that you're helping people that come behind you to know about the experience and how it can be changed to make it better.

    11:14 Now, when you are done and your survey is done, you just raise your hand and they will dismiss you. But you just want to get up and walk around.

    11:23 You want to make sure you talk to the proctor or the TA and let them know you are done. You will not get your score in the test center.

    11:31 And this is such a high stakes, dramatic kind of thing.

    11:34 You can understand why you wouldn't get it in the testing center.

    11:38 Now, at that moment the computer knows if you passed or failed, the proctor does not.

    11:44 Okay. So there's lots of ways that we can talk to you about how you get your results.

    11:47 But the computer knows the proctor does not.

    11:50 So they can't tell you whether you did or did not pass.

    11:53 And I promise you on the drive home because I've got your phone calls, I think I passed.

    11:57 I think I failed. I think I passed.

    11:59 I think I failed. That's how your emotions are going to feel until you actually get your results. Now, if you get early results from the Pearson Vue people, those are accurate.

    12:08 They can send you a results.

    12:09 And I've never seen anyone have a problem with that.

    12:12 Other students have tried to reregister.

    12:14 That test doesn't always work.

    12:16 Okay. So if you go back and you try to reregister and it lets you register, you must have failed. Hey, I had that happen to a student.

    12:22 They were able to reregister all the way through paying again for their test.

    12:26 So they went into deep mourning.

    12:28 You know, they told everybody they failed.

    12:30 Their life was all this kind of dramatic stuff.

    12:33 And four days later, they found out that they had passed.

    12:36 So that test sometimes work when you try to reregister, but it doesn't work every time.

    12:43 I'm not saying I wouldn't try it because I would be neurotic, but it's really not the most accurate. But if you get early results, I think they charge you an extra less than $10 or it may have gone up by now and you get those results and they say you've passed.

    12:55 That's awesome.

    12:57 Those are correct.

    12:58 But you cannot go to work until your name shows up on the State Board of Nursing website as being licensed.

    13:06 That's when you can start working in acute care or wherever you're setting is.

    13:11 Now everyone's asked like, how many case studies should I expect? And I wanted to take a couple of minutes to break it down for you.

    13:17 So it makes sense if you get 85 questions right, that's the minimum.

    13:21 Expect a minimum of three case studies that will count.

    13:26 But you might also have some other case studies as part of those 15 unscored items.

    13:31 So the answer is every test could be a little bit different, but you will get a minimum. Everyone gets a minimum of three case studies that count.

    13:39 Now, if you have more than the minimum, you have more than 85 questions.

    13:42 It is possible that you may get even more opportunities to see case study questions and they do count and you might see extra case study questions, extra bow tie questions or extra trend questions.

    13:53 Don't let your mind go south.

    13:56 Just make sure you stay calm in the moment.

    13:58 Monitor your breathing.

    14:00 Take a. Break when you need it.

    14:01 And you've got this.

    14:04 Now, what percentage of the client need categories are the case studies? Clinical judgment is an integrated process, but the case studies will span any number of content areas, and so they're counted independently of the content area specific items. Let me make sure that makes sense.

    14:21 Now, the other questions will be following that percentage right along those eight categories like we laid out for you.

    14:28 The case studies can come from any category, okay? And they're counted separately as a different area.

    14:34 So they're not in those eight category percentages.

    14:39 Now when you're taking the NCLEX, what happens if I get more than 85 items? Am I failing? No.

    14:45 And this is the one thing I could go with you and keep telling you while you're taking the test. You're doing fine.

    14:52 Nobody cares how many numbers of questions you have.

    14:55 We just want you to pass.

    14:57 So I wish everyone would not have to go past 85, but the majority of people will.

    15:03 So you have to tell yourself, I'm just not done yet.

    15:07 Y e t I'm going to get there.

    15:10 I'm just not done yet.

    15:12 And I came in here Ready that I could have to go to 150 and I can make it all the way to 150 and still pass.

    15:20 I've lost count of the number of students that have taken the maximum number of questions on the NCLEX and passed.

    15:26 So keep your mind straight and clear.

    15:29 Remind yourself that you can do it.

    15:33 So that's it.

    15:35 That's everything you need to know about how the NCLEX is put together, who's responsible for it, how you get ready for it, and what you should do the day before.

    15:44 Now, if you have any other questions, please make sure you send them to us and we'll answer them. Just join us on our discord.

    15:50 That is a community for student NURSES only, and we would love to answer any specific question that you have now.

    15:57 What are you waiting for? Get started.

    15:59 Dig into that course and you can be prepared for the NCLEX exam.

    About the Lecture

    The lecture NCLEX-RN®: The Exam by Rhonda Lawes, PhD, RN is from the course NCLEX-RN® Introduction to the Exam.

    Author of lecture NCLEX-RN®: The Exam

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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