NCLEX-RN Study Tips: How to Answer Multiple Choice Questions

Cheryl Armstrong, MS, RN
May 3, 2022

Content’s one thing, but what about the format of NCLEX questions?

That’s what we’re addressing in this week’s NCLEX study tips: How to strategize for multiple choice questions.

If you’ve heard anything about National Council Licensure Examination, you probably know that the majority of the questions on it will be in a multiple choice format. Others will be those that are considered Alternate Format type questions, which we’ll deal with next week.

1. Expect These Multiple Choice “Themes”

You’re going to see two different kinds of multiple choice questions. This question format will include priority (what should the nurse do first), as well as positive (true) and negative (false) questions. Remember, as we discussed in last week’s NCLEX study tips, priority questions often have more than one “right” answer, but there’s always a correct action to choose first.

2. Narrow Down the Positive Statements

Positive questions will present four statements, and only one of them will be the correct answer; all of the others answers are incorrect. These might be called “classic” multiple choice questions, but at the very least they’re the type of questions that most of us are more comfortable with. For these questions, you need to cross out any answers that are obviously wrong to narrow down your options. By ignoring what’s obviously incorrect, you’ll be able to concentrate more on choosing the one correct answer.

3. Think Differently for Negative Questions

Negative questions are just the opposite: They present three answers which are correct statements, and one is incorrect. Here you are looking for that incorrect statement. These are much harder for many people, because in test-mode our minds want to automatically choose a correct statement as soon as you see it. This means you need to look vigilantly for signs that a question is negative instead of positive. When you see it, you have to adopt the paradoxical mindset that the “correct” answer is wrong.

4. Don’t Expect “Except”

The old NCLEX used the word “Except” when asking a question (such as “all of the following are true except which option”). That one little word made things clear, and its absence has made things trickier. Instead, you should expect to see questions phrased closer to “which option indicates the client needs further instruction?”

This means the same thing as using the word “except” (i.e. that one of the options isn’t sufficient, and in simpler terms: that all of the options are correct statements except one). In this case and others like it, you should look for the option that is an incorrect statement, which makes it the correct answer. Confusing? It can be, which is why it’s so important to take your time and really read the question. We’ve said it before: Paying close attention and comprehending what’s asked of you will keep you from jumping to an answer. If you do that, you’re going to look for something that’s a correct statement—which would, in this case and in all negative questions, be the wrong answer.

P.S. We love feedback. Post to our Facebook page or give us a shout on Twitter with comments or requests for specific information you’d like to see in the series.

Happy studying, and see you with more NCLEX study tips next week!

– Cheryl Armstrong, MS, RN
– Britt Baer, RN, MSN-HCSM, SANE