June 4, 2021

The Ultimate NCLEX Study Plan:What You MUST Know to Pass(in 2021)

Leona Werezak RN BSN MN & Shelly Luhning RN BScN MN ENCC CCNE

You’re done nursing school (or almost)! Let’s see that happy dance! Great job!

Now it’s time to get ready for the big event that all your education and training has prepared you for—passing the NCLEX!

But where do you start? You covered soooo much information in your program. Do you need to review ALL of it? Where should you start? Is the NCLEX like the exams you took in nursing school? Are you ready to figure this out on your own? Or would you like someone to show you the ropes and take you through what to do so you know you’ll pass?

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Sounds like you need a plan—an NCLEX study plan!

Students are often surprised to find out the NCLEX exam is very different than the exams they took in nursing school. We’ve even met students who finished at the top of their class but failed the exam (a couple times or more) because, in their words, they “didn’t know how to read the questions”, even though they felt they “knew their stuff”.

The good news is plenty of students pass with the 75 question minimum because they’re well-prepared and know what to expect. They go into the exam with knowledge and confidence—and ace it!

And you can too! We’re going to share with you the best NCLEX study plan we use that results in a 100% NCLEX pass rate for students we work with!

Ready to do this? Let’s look at a study plan that works.

Components of a Successful NCLEX Study Plan

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There are five parts or components that are equally important to include in your study plan. Each of the five components are explained in a lot more detail below.

1.  Make a Personalized NCLEX Study Plan

Starting with an overall plan is crucial if you want to get to your final destination—passing the NCLEX. You wouldn’t start out on an exciting trip to someplace you’ve never been without doing some research and planning first. Lack of planning a big trip could cost you a lot more money than you expected, and end up in disappointment, not to mention other problems.

Learning how to study for the NCLEX is no different. If you don’t know the things we’re going to share with you below and prepare accordingly, chances are high it’s going to cost you a LOT of money (lost income you could be earning as a nurse, fees to re-take the NCLEX, an awesome job you had lined up, etc.) and a lot of time (months maybe) if you don’t pass the exam and get your nursing license.

Complete a Self-Assessment

Know thyself! Completing a self-assessment is a crucial first step so you can step up a realistic timeline for your NCLEX study planand schedule a date when you will take the exam.

How much time are you able to study each day? Most students schedule 3-6 hours/day to study for the exam and take at least 1 day off everything (studying and work) each week to relax and recharge their batteries. 

What time of day do you feel most mentally alert and able to study? Do you have a work schedule or family responsibilities you have to schedule your study time around? 

Be sure you’re studying during a time when you would be taking the NCLEX—not late at night.

Other key things to make note of in your self-assessment include:

●  Your strengths and weaknesses

○  Do you struggle with multiple choice exams? Or select all that apply (SATA) questions?

○  Does anxiety interfere with your test-taking ability?

○  What distracts you from studying? How do you minimize distractions as much as possible?

●  Content areas or concepts you struggle with & will need to spend extra time reviewing. You may want to look for a tutor or peer to help you with learning this content better too.

●  Your ability to understand, think critically, & apply pathophysiological concepts.

●  Finding new ways to critically think and learn content—don’t memorize!

If after doing your self-assessment you feel like you need some help or you know you struggle with some concepts or test-taking but you’re not sure why, you may want to consider taking a review course for NCLEX RN

Remember! This is about passing the exam as quickly as possible so you can get started with your career. Spending some money to take a really good review course can save you money, time, and anxiety in the long run. Contact our expert NCLEX faculty for free if you’d like to learn how we can help you pass the exam.

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Start By Reviewing Foundational Nursing Content

The idea with your NCLEX study plan is to start with foundational content that applies across the board in nursing regardless of the patient group, disease process, or area of practice. Some examples of foundational content you need to review include:

●  The nursing process (also known by the acronym ADPIE which stands for assessment, diagnosis, planning, implementation, and evaluation).

●  Anatomy and physiology (normal and abnormal findings including vital signs; age & gender specific differences; growth & development through the lifespan).

●  Principles of microbiology (such as principles of medical & surgical asepsis, modes of disease transmission, standard and isolation precautions).

●  Principles of therapeutic and professional communication.

●  Nursing scope of practice, patient rights, nursing code of ethics.

Include the Client Needs Categories in Your NCLEX Study Plan

Client Needs was selected by the NCSBN as the basis for the NCLEX-RN exam because it provides a universal structure for defining nursing actions and competencies. And it focuses on clients in all care settings. 

The Client Needs Categories include four broad categories important to safe, effective and holistic nursing care.

We’ll discuss these in more detail in #2 below but to start with, the four categories include:

1.  Safe and Effective Care Environment

2.  Health Promotion and Maintenance

3.  Psychosocial Integrity

4.  Physiological Integrity

2.  Understand the NCLEX-RN Exam and Test Plan

Going head-to-head with a fierce opponent or competitor, you need to KNOW what you’re going up against—if you want to win. Positive thinking, relying on past victories (ie. great marks in nursing school), and completing a handful of practice exams and then thinking you’re ready to take the NCLEX is like being a good marathon runner and thinking you’ll be successful at climbing Mount Everest without further preparation. It’s a recipe for trouble. 

Running marathons and elite mountain climbing have things in common—but LOTS of differences. The NCLEX-RN exam is no different. 

For example, you might have sat through some long exams in nursing school. But I bet none of them were 5 hours long which is the maximum length of time you could be working on the NCLEX exam. 

As an important part of your NCLEX study plan,you need to become very familiar with the NCLEX-RN exam and Test Plan. Some key things to know and understand are:

●  How do you pass/fail the NCLEX?

●  How is the NCLEX Test Plan generated and what Client Needs Categories and Integrated Processes are tested?

●  What is Computerized Adaptive Testing (CAT) and what does it have to do with the NCLEX exam?

●  What is the NCLEX exam environment like and what you can expect when you arrive (rules, taking breaks, how the computer and exam works, what if you have a question during the exam, etc.)?

How Do You Pass/Fail the NCLEX?

There are a minimum of 75 “test items” (questions) and a maximum of 145 questions on the NCLEX-RN exam. It’s possible to pass or fail the exam by answering the minimum or maximum number of items, or any number of items (questions) between 75 and 145. 

The exam ends when you answer enough items to either pass or fail the exam. It also ends if the 5-hour maximum time limit is reached.

Passing or failing the NCLEX occurs in one of three ways:

a) The 95% Confidence Interval Rule

This means that the computer will stop administering test items when it is 95% certain that your ability is either clearly above orclearly below the passing standard. This is the most common way most candidates pass or fail the exam.

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b) The Maximum-Length Exam

In this scenario, if you are very close to the passing standard—the computer continues to administer questions until the maximum number is reached and then considers only the final ability estimate:

●  If the final ability estimate is ABOVE the passing standard, you pass the exam.

●  If the final ability estimate is AT OR BELOW the passing standard, you fail the exam.

c) The Run-Out-Of-Time Rule (R.O.O.T)

If you run out of time on the exam (use the full 5 hours), the final ability estimate is determined from all the responses on the items completed on the exam.

●  If the final ability estimate is ABOVE the passing standard, you pass the exam.

●  If the final ability estimate is AT OR BELOW the passing standard, you fail the exam.

Test Plan for the NCLEX Exam: Cognitive Domain (Bloom’s Taxonomy)

The NCLEX-RN test plan evaluates candidates’cognitive domain as explained by Bloom’s Taxonomy

The Cognitive Domain consists of six major categories starting with the lowest or most basic level of learning that requires recall or identification of facts up through increasingly complex and more abstract levels of learning. 

The six categories from lowest to highest level of learning are:

●  Knowledge

●  Comprehension

●  Application 

●  Analysis

●  Synthesis

●  Evaluation

On the NCLEX, the Cognitive Domain is used as the basis for constructing and coding questions for the exam. Most questions on the NCLEX are written at the application and analysis levels.

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How Is The NCLEX Test Plan Generated and What Is Computerized Adaptive Testing (CAT)?

The NCLEX-RN exam is based on an analysis of practice of new graduates. This means the exam focuses more on what new nurses will experience in acute care settings where new graduates are most likely to work. Nursing specialities are NOT tested.

The exam also uses Computerized Adaptive Testing (CAT). This means that the exam is created as you answer each question. The computer’s goal is to determine your ability in relation to the passing standard. 

Every time you answer a test question, the computer re-estimates your ability. With each additional answered question, your ability estimate becomes more accurate.

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What Client Needs Categories Are Tested?

As explained above, the NCLEX is based on four broad Client Needs Categories. These categories consist of six sub-categories that test your ability to provide appropriate nursing care in these areas:

1. Safe and Effective Care Environment

a)  Management of Care

This sub-category tests your ability to provide and direct nursing care that promotes a care delivery setting to protect clients and health care staff.

b)  Safety and Infection Control

In this part of the NCLEX, your ability to protect clients and health care staff from environmental and health hazards is tested.

2. Health Promotion and Maintenance

This category tests your nursing care to determine if you’re able to incorporate:

●  Knowledge of growth and development principles

●  Prevention and/or detection of health problems

●  Assist with the implementation of strategies to help clients achieve optimal health

3. Psychosocial Integrity

The category of Psychosocial Integrity tests your ability to promote and support the mental, emotional, and social well-being of clients experiencing stressful events. It also assesses your ability to provide care and support for clients with acute or chronic mental illness.

4. Physiological Integrity

Physiological Integrity tests your ability to promote the physical health and wellness of clients by:

●  Providing care and comfort

●  Reducing client risk potential

●  Managing health alterations

a) Basic Care and Comfort

 Tests your ability to provide comfort and assistance to clients in their performance of activities of daily living.

b) Pharmacological and Parenteral Therapies

 This part of the NCLEX-RN exam tests your ability to provide care  related to the administration of medications and parenteral therapies.

c) Reduction of Risk Potential

 Refers to your ability to reduce the likelihood that clients will develop complications or health problems related to existing conditions, treatments, or procedures. 

d) Physiological Adaptation

 Here you’re tested on your ability to manage and provide care for clients with acute, chronic, or life threatening physical health conditions.

To give you an idea of how much time to devote to each Client Need Category in your NCLEX Study Plan, we’ve included the table below that shows what percentage of questions on the NCLEX test these categories and areas.

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For more in-depth information about these categories and sub-categories tested, be sure to see the NCSBN 2019 NCLEX-RN® Test Plan

What Integrated Processes Are Tested?

The NCSBN has identified five processes fundamental to the practice of nursing. These processes are “integrated” throughout the Client Needs categories and sub-categories. This means that at least (1) one of these processes is integrated and assessed in every NCLEX exam question. 

The five Integrated Processes included throughout the Client Needs categories are:

●  Nursing Process

●  Caring

●  Communication and Documentation

●  Teaching/Learning

●  Culture and Spirituality

Be sure to check out our free on-demand webinar titled NCLEX-RN: The Essentials You NEED to Know! for more information about the NCLEX test plan and how to study for the NCLEX so you pass.

What’s The NCLEX Test Environment Like and What Are The NCLEX “Rules”?

The NCSBN Test Plan provides lots of information about preparing to take the exam but here are the highlights:

●  You don’t need any computer experience to take the NCLEX exam.

●  There is a general guide and test taking tip provided before you start the exam.

●  An exam proctor is present the entire time of your exam. This person will explain how to use the computer so you understand how to complete the exam.

Here are some other things to know about the exam too—and a recap of a few things we mentioned already!

●  No food or drink is allowed in the exam room.

●  No electronic devices are allowed (phones, watches, etc.).

●  No scrap paper may be brought in—an erasable board and marker are provided in the exam room.

●  The exam is video and audiotaped.

●  There is a minimum of 75 test items (questions) and a maximum 145 test items (questions) on the exam.

●  The NCSBN recommends taking 1-2 min. per test item/question as a good exam pace in case the maximum 145 questions are administered.

●  15 test items (questions) on the exam will be unscored pretest questions.

●  Maximum time length of the exam is 5 hours.

●  The time allotted for the exam includes an introductory screen, all optional breaks and the exam itself.

●  Two pre-programmed optional breaks are allowed during the exam. The 1st optional break is after 2 hrs. of testing. The 2nd optional break is after 3.5 hrs. of testing.

●  An exam proctor is present at all times.

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Answering Items/Questions on the NCLEX Exam

Once you sit down in front of the computer to start the exam, some things you’ll want to know are:

●  How does the computer exam work? 

●  How do I answer questions on the exam? 

●  What if I don’t know the answer to a question? 

●  Can I skip a question and go back and answer it later?

●  How will I know when I’m done the exam?”

For starters, there’s a great tutorial that explains what you can expect with the exam software on the NCSBN site. 

NCLEX test items/questions are presented one at a time on the computer screen. You can view each question as long as you like—but it’s NOT possible to go back to a previous question once you select and confirm an answer by pressing the <NEXT> button.

What if you don’t know the answer to a test item/question? 

You have to answer every question that is presented to you on the screen, even if you’re not sure of the correct answer. That’s because the computer won’t allow you to move on to the next question without answering the one on the screen before it. 

Candidates need to make their “best guess” if they’re unsure of the correct answer before they can proceed to the next question.

3.  Learn How to Read NCLEX Exam Questions

An important part of knowing how to study for the NCLEXincludes learning how to read NCLEX test items/questions.

What Types of Questions Are On the NCLEX RN Exam?

With this question, most candidates want to know the exam question format since there are different ways to study and strategically prepare for different exam formats.

The NCLEX RN exam may have test items/questions presented in any of the following formats:

●  Multiple choice

●  Fill-in-the-blank

●  Select All That Apply (SATA)

●  Prioritizing (Ordered response)

●  Chart or exhibit

●  Questions that contain an illustration or figure

●  Drag and drop

The first three types of question formats are pretty straightforward. 

To clarify what the remaining four types of questions could look like, it’s easiest to explain that by showing you a sample NCLEX question.

 Prioritizing (Ordered Response) Question

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Chart or Exhibit Question

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Answer: 4. Blood glucose level

Figure or Illustration Question

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Drag and Drop Question

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Answer:  Inspection – Palpation – Percussion - Auscultation

Learning how to read NCLEX questions is one of the most important things you can do to prepare for the exam. 

At NCLEX Education, we’ve developed a copyrighted algorithm that we teach students to use to break down test items/questions piece by piece so they don’t miss key parts of the question. This algorithm has been tested and proven to greatly improve students’ chances of answering questions correctly.

Be sure to contact us and ask more about the algorithm we use if you’re interested in how it could help you too.

4.  Understand the Exam Content

Now that you know how the NCLEX exam is structured, the Client Needs categories and Integrated Processes that are covered, and how test items/questions could be structured, it’s time to roll up your sleeves and dig into your books and class notes. You’re about to do your most epic nursing review ever!

Revisit the Self-Assessment You Did Earlier

So where should you start? 

To flush out a more detailed NCLEX study plan and schedule, it’s a good idea to begin by looking back at your self-assessment. 

Do you have difficulty answering multiple choice, SATA, or other types of exam questions? Is your pharmacology or pediatric nursing knowledge a bit weak?

Not sure where you’re weak or where you need to improve? Don’t worry! You’re not alone! 

We find many students don’t know where they’re weak or where they need to improve—even if they’ve been unsuccessful on the NCLEX previously and have their feedback report identifying their weak areas. 

That’s because each time you take the exam, it’s a different exam with different questions because it’s CAT adaptive. So the next time you take it, you could have different weak areas in your report—and be unsuccessful on the exam again.

Look for a coach or mentor that can help you identify and improve on ALL your weaknesses before you start studying for the exam.

At NCLEX Education, we prepare customized assignments that identify ALL your weak areas. Based on these findings, we prepare customized assignments and work with you to strengthen those areas. Then we test those areas specifically until you’re well above the passing standard.

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Look at Test-Taking Strategy Textbooks

Test-taking strategy textbooks are a good place to start adding more detail to your NCLEX study plan because they:

●  Show/explain the best way to study for the exam

●  Explain how to better understand exam questions

●  Teach you how to approach NCLEX-RN questions

●  Explain alternate exam questions and strategies for prioritization questions

Three common test-taking strategy textbooks students find helpful include the following:

Review Guides

The purpose of review guides is to expose you to as much content as possible in one resource. These can be real time (and sanity!) savers when you’re studying so you’re not jumping from one book to another, back and forth, and trying to remember what you studied and what you haven’t. 

However, some review guides simply cover a lot of content without providing rationale. Be sure to look for a review guide (or NCLEX prep program) that helps you understand the content, not just memorize it.

Key things to look for in a good NCLEX-RN review guide include:

●  Information is presented using the Nursing Process.

●  Book is well-referenced throughout.

●  Helpful diagrams, tables and figures are included to help with information presentation.

●  Addresses the Client Need categories of the NCLEX-RN test plan.

Here are four review guides students most commonly use:

Preparation Guides/Question Tools

Preparation guides are useful after you’ve completed enough content review. These guides focus on practice questions so they help you figure out if you know the content well enough or where your knowledge base is still weak so you can go back and review that content further.

When choosing one of these guides/tools, look for these important things:

●  You’re able to complete practice CAT (computer adaptive testing) exams.

●  They target specific content areas.

●  They include NCLEX-RN practice exams.

Some popular prep guides/question tools include the following below. Just be aware that most of the guides we’ve reviewed don’t include all of the components we discuss here for a successful NCLEX study plan. 

Be sure to watch our free on-demand webinar titled NCLEX-RN: Where Do I Start?  for more information about these resources and how to get started.

NCLEX resources and prep are not cheap! But neither is failing the exam. Time lost earning an RN wage, costs of retaking the exam, not to mention the anxiety and stress of retesting.  We've done a cost breakdown comparing what you need if you DIY versus enroll in an NCLEX prep program :

Common Mistakes When Preparing for the NCLEX-RN

We’ve helped thousands of students and unlicensed nurses prepare for and pass the NCLEX-RN in our comprehensive Faculty Facilitated program. Some were first-time test takers and some were taking the exam for the ninth time. 

We’ve seen the most common mistakes students make when preparing for the NCLEX and we want to share those with you so you don’t make them too!

Mistakes include:

●  Not making an NCLEX study plan.

●  Trying to memorize content.

●  Not practicing NCLEX style questions.

●  Not practicing CAT adaptive exams.

●  Not preparing for the 1st exam attempt.

●  Not learning the NCLEX-RN test plan.

●  Studying in silos (eg. reviewing all pharmacology at once without using a resource or guide that incorporates pharmacology with disease processes, anatomy & physiology, assessment, etc.).

●  Rushing the next exam attempt/not changing exam preparation.

●  Not covering all of the possible content.

●  Not addressing all 5 components of preparation listed in this NCLEX study plan.

5.  Prepare Mentally & Physically for the NCLEX Exam

Preparing Mentally

This last component may seem obvious but we’ve seen many candidates overlook how important it can be. If you know you have test anxiety that interferes with how well you do on exams, you’ll want to get some help with this before studying for the NCLEX.

There are different strategies for managing anxiety that really work. However, some strategies work great for some people and not so well for others. 

Anxiety and depression can also occur together. Either and both of these mental health conditions can seriously impair your ability to concentrate and retain information when you’re studying. Depression can also make it very difficult to motivate yourself to study. 

If you’re concerned about either of these or other thoughts you’re having, be sure to see your doctor or primary health care provider to discuss how you’re feeling. 

Medication may be prescribed in consultation with your healthcare provider to help you. However, some medications take weeks or longer to demonstrate a therapeutic effect. And many of these medications have common initial side effects such as difficulty concentrating or sleeping that can take weeks or longer to subside. 

Take care of your mental health first before jumping into studying for the NCLEX.

Our NCLEX faculty coaches help students every step of the way with phone calls, zoom meetings, emails, a private Facebook group, and specific strategies individualized to each person’s needs. So don’t hesitate to reach out to us if you think you could benefit from this kind of coaching and help.

Preparing Physically

Exam endurance and exam practice are also crucial factors to include in your NCLEX study plan. Remember the exam can be up to 5 hours long. That means you should do some practice exams that take that long (or almost!) to complete. And ideally, you want to practice CAT exams (computer adaptive exams) since this is how the NCLEX exam works. Practicing CAT exams will give you a good idea how much time the real NCLEX may take you. 

Be sure to take some days off studying to rest and let your brain recharge. Do some type of physical activity in between your study periods to help you re-energize.

Three or four days before the exam, make sure you’re well rested and feeling good. 

And finally, remember the NCLEX-RN exam (and your study plan) is like a marathon, not a sprint. 

Take plenty of time to complete each step of this NCLEX study planstarting with your self-assessment. 

If you feel this is a lot to do on your own and would like some help, don’t hesitate to reach out to our team of expert NCLEX faculty who are happy to help you.

Now put on your marathon mindset and get started on your NCLEX study plan. You got this!

Article written by 
Shelly Luhnning & Leona Werezak
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