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NCLEX Exam Tips and Strategies

Sep 12, 2025

Overview

This lecture covers practical strategies and key tips for answering NCLEX-style nursing exam questions, addressing test anxiety, and improving exam performance.

Reasons for NCLEX Failure

  • Many students fail not due to lack of knowledge, but difficulty with NCLEX question styles and test anxiety.
  • Most students who retake the exam after proper preparation eventually pass.

NCLEX Question Answering Strategies

  • Read the question stem and think about related knowledge before viewing answer choices to avoid bias.
  • Identify keywords in the question to determine if it seeks an assessment or intervention.
  • Use the process of elimination by crossing out obviously incorrect answers and trust your gut.
  • For “Select All That Apply” (SATA) questions, treat each option as a true/false statement individually.

Prioritization & Patient Safety

  • Prioritize unstable patients (acute, rapidly changing conditions) over stable patients (chronic, unchanged).
  • Use ABCs (Airway, Breathing, Circulation) to determine which patient to see first.
  • Choose least invasive interventions before more invasive ones for patient safety.

Therapeutic Communication

  • Avoid yes/no questions unless assessing for self-harm.
  • Use open-ended questions to allow patients to express feelings and gain more information.
  • Responses should acknowledge patient fears and invite further discussion.

Exam-Specific Tips

  • “Assess unless in distress”: Intervene first in emergencies; otherwise, begin with assessment.
  • Be wary of absolute answer choices (words like "always" or "never") as they are usually incorrect.
  • Prioritize physical needs (air, water, food) over psychosocial needs (Maslow’s hierarchy).
  • If you have never heard of an answer in class or books, avoid choosing it.

NCLEX-Style Question Approaches

  • For “What is the nurse’s first/best action?” pick the initial/most effective step.
  • In stepwise procedures, choose the earliest step (e.g., hand hygiene before catheter insertion).
  • For bleeding in late pregnancy, assess fetal heart tones first (least invasive, most urgent).

Key Terms & Definitions

  • NCLEX-style questions — Nursing exam questions that test application and prioritization skills.
  • Test anxiety — Nervousness affecting performance during exams.
  • ABCs — Airway, Breathing, Circulation; used for prioritizing patient care.
  • Therapeutic communication — Strategies for effective patient interaction, focusing on open-ended responses.
  • Least invasive — Intervention causing the fewest physical risks to the patient.

Action Items / Next Steps

  • Watch the full NCLEX review video for more safety topics.
  • Practice using the outlined strategies with NCLEX-style practice questions.
  • Review Maslow’s hierarchy and ABCs for prioritization questions.