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NCLEX: What’s New in 2013 and How to Prepare

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Congratulations on the decision to join the nursing profession. As the semester begins you will face many new challenges and responsibilities. At times these may seem overwhelming, but if you develop a sound plan for studying and retaining the information you will achieve your goal of becoming a nurse. The NCLEX® is the final step in attaining this goal. Success in nursing school and ultimately on the licensure exam depends on developing strong study skills and continual reinforcement of what you have learned. In 2013 the test plan changed. The difficulty level of the passing standard increased and the categories changed. In this article, Wilda Rinehart, RN, BSN, MSM, FNC, and FPNP of Rinehart & Associates, walks you through those changes and what you need to know before walking into the exam room.
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NCLEX® is an exam that measures safe beginning nursing practice. It is intended to measure the candidate’s knowledge, skills and ability to practice nursing.

Success in nursing school, and ultimately on the licensure exam, depends on developing strong study skills and continual reinforcement of what you have learned. By the time you enter nursing school, you are probably aware of whether you are a visual, auditory or a hands-on learner. Nursing school will require you to use each of these modalities in the classroom, skills lab, and clinical setting.

There are three important things to ask yourself:

  1. What do I need to know to be successful in both nursing school and on the NCLEX®?
  2. What is “CAT”?
  3. How do the test writers develop the questions used on the NCLEX®?

What do I need to know to be successful in both nursing school and on the NCLEX®?

Knowledge of the Content Being Tested

In order to be successful in nursing school and on the licensure exam, you must have an in-depth knowledge of many areas, including anatomy and physiology, microbiology, pathophysiology, nutrition, pharmacology, and of course nursing. There is no substitute for knowing the material. You will be expected to read and comprehend large amounts of material and to take notes. If you are an auditory learner, you may have difficulty listening to lectures while taking notes. Check with the faculty to see if audio-taping is permitted. Many instructors allow students to record lectures for individual use, and some lectures and PowerPoint presentations can be downloaded directly from the internet. Listening to the lectures during your commute allows you to reinforce what you have learned in the classroom.

Develop good study habits by having a dedicated time and place for study.

Develop a study group of friends that are dedicated to the same goals and that serve as a support group. Often family members do not realize how difficult nursing school can be and how much time and effort it takes to be successful. If possible, limit work to no more than 20 hours per week. I realize that nursing students are mothers and fathers with family responsibilities, but passing nursing school requires approximately 2-3 hours per day of study time outside the classroom and clinical setting. Begin reviewing material to be tested several days prior to the exam date. Rushed study the night before or morning of the exam doesn’t work well for most students.

Testing Skills

In order to be a successful test taker, the student must learn and practice testing skills. It is not enough to simply know the facts about a particular disease or condition. Nursing students must be able to apply knowledge to a given patient situation. You were probably surprised when you took your first nursing exam and found out that many of the questions required you to analyze information and to apply it to a particular scenario, with questions such as “Which action should receive priority?” or “Which patient should be seen first?” Other questions include alternative items, such as check all that apply, place in sequence, and fill in the blank.

Both the NCLEX® RN Exam Cram and the NCLEX® RN Exam Prep book provide a full discussion of testing tips as well as analysis and application questions. The Exam Cram NCLEX®-RN Practice Question book provides the student with five test banks and CD.

Ability to Critically Think

As stated earlier, the successful test taker must be able to apply knowledge to a patient situation. The student who is a critical thinker is able to analyze information that is given and develop a plan of action. This is especially important on the NCLEX®, since the majority of questions above the passing standard are at the application and analysis level.

What is CAT?

CAT stands for Computer Adaptive Testing. In 1994 the exam changed from the paper-pencil exam to a CAT exam style. This test is much better than the old way of testing since it asks questions at the candidate’s level of knowledge. In years past all candidates took the same number of questions as well as the same questions. This meant that some candidates received questions that were either too difficult or too easy. With the CAT exam, the candidate is asked questions dependent on the correctness or incorrectness of the previous answer. If the candidate answers the question correctly, a more difficult question appears next. If the question is answered incorrectly, an easier question will follow. The test continues until the candidate runs out of time or shows consistency above or below the passing standard.

In 2013, the test plan changed. The difficulty level of the passing standard increased and the categories changed. Below is a breakdown of Client Needs, one of the major components of the exam. The test plan can be seen by visiting the National Council of State Boards of Nursing web site at http://www.ncsbn.org.

  • Safe Effective Care
    • 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 12-18%
    • Reduction of Risk Potential 9-15%
    • Physiological Adaptation 11-17%

How do the test writers develop the questions used on the NCLEX®?

The questions included on the NCLEX® exam are written by practicing nurses and nurse educators with experience in all fields of nursing. Some of your instructors may have helped with constructing the exam. Once a question is written, it passes through several committees prior to being included on the actual NCLEX® exam. These committees make sure that all the questions are accurately stated, that answers are plausible, and are free of cultural, gender, and racial bias. Statistical information is obtained on each question to determine reliability and validity. Although you may be nervous about taking the NCLEX®, be assured that it is a highly developed test that reveals those candidates who possess the knowledge needed to be safe beginning practicing nurses.

Your decision to become a nurse requires dedication and persistence. Whether you are a student nurse or a graduate nurse preparing for the NCLEX® exam, Rinehart and Associates is happy to assist you with the Exam Cram books or with our live review seminars. For those who prefer to review in the privacy of home, Rinehart and Associates offers an online review. To learn more about the NCLEX® Exam Cram series or our review services please visit our website at www.nclexreview.net. Additional resources are available from Pearson Education or by visiting informit.com. Exam Cram NCLEX® RN, Exam Cram NCLEX® RN Prep, and Exam Cram NCLEX® RN Practice Question books are available on our website and major bookstores.

NCLEX® is a registered trademark of the National Council of State Boards of Nursing

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