The NCLEX is different from most tests you’ve taken during school. Instead of measuring your basic nursing knowledge, the NCLEX assumes you know your stuff, then tests how well you can apply it to real-world nursing scenarios. NCLEX questions can feel complicated, and answering them correctly requires careful reading, critical thinking, and strategy. You’ll want to break them down and analyze them before leaping to an answer.
That’s where we come in. This guide will equip you with specific strategies to teach you how to break down NCLEX questions, analyze them, and answer them confidently.
Read on to learn how to understand all aspects of an NCLEX question, apply nursing knowledge and theory, and successfully qualify as an RN.
There’s no point in denying it — NCLEX questions can be confusing. Many test takers with great nursing knowledge and instincts slip up by misreading the exam. Avoid this pitfall by breaking down NCLEX questions to understand their format and phrasing. When you get to the core of what they’re asking, you can let your nursing knowledge shine.
The majority of NCLEX questions are multiple choice and formatted with a stem and several answers. The stem lays out the nursing scenario and asks a question. It can be a short sentence or more detailed, with up to a paragraph of information. The answers are the multiple choice options. When you’re reading a multiple choice NCLEX question, read through the stem and pay close attention to whether it is a positive, negative, or priority question.
A. Positive questions ask you to identify the one correct answer. Positive questions are the most straightforward and often include keywords like the following:
B. Negative questions ask you to identify a false answer. The wording on negative questions can be hard to catch because the test rarely says something as clear as “the following are true except…” Keep an eye out for words and phrases that indicate that a qualified nurse would step in, stop a student from performing certain actions, or would teach a student more. Some words to look out for in the question stem are:
C. Priority questions ask you to choose which answer from several correct options is the most important, most correct, or should occur first. Keywords that indicate a priority question include:
Read more about how to answer NCLEX priority questions, and check out this blog post for more multiple choice tips and strategies.
The NCLEX uses an adaptive learning model to administer the exam which means everyone gets a slightly different mix of NCLEX questions, but you can expect that you’ll encounter some that aren’t formatted as multiple choice. These are called alternate format NCLEX questions. Below are a few of the different types of alternate-format questions you can expect to encounter:
The same close reading and critical thinking skills you’ll use for multiple choice apply to alternate format questions. Check out this blog post for more information on alternate format NCLEX questions.
After you’re comfortable with the question format, the next step in breaking down NCLEX questions is to look for key information. Keep a sharp eye out for:
Pay close attention to keywords that indicate what each NCLEX question is asking for. For example, a question may provide client details and a scenario, then ask you how you might educate the client on home care. The word “educate” is key here, and offers a huge clue to which answer is correct. If one of the options explains the correct medical treatment for the patient, it could distract you from the correct answer about appropriate patient education.
Expert tip! If the primary focus of the question is “ client education,” eliminate distraction answers by honing in on education-only responses.
You know the NCLEX question’s format and you’ve pulled all the data to help you answer it. Now, let’s get a handle on the overarching client scenario.
Rephrasing the question in your own words will help you get to the core of the question. You’ll prove to yourself that you have a good handle on what the question is asking, which may also give you crucial insights into the client’s condition that will help you answer the question correctly.
When you break down NCLEX questions, remember that every detail is relevant. Don’t assume anything about the patient scenario that isn’t explicitly stated, but don’t throw out any information they do give you. If you ever ask “but what if…” you’ve changed the question. Look for these clues when establishing the patient’s scenario and context:
In Joyce’s nursing programs, students learn about holistic nursing practices a that knowledge can be applied here. Consider Maslow’s Hierarchy of Needs and look at the question with insight into a whole person with physiological and psychosocial needs. This is especially important when encountering questions about therapeutic communication, which you can read more about in this article.
Multiple choice NCLEX questions will have one correct answer and three decoy answers. These strategies can help you rule out incorrect options and eliminate the distractors :
If there are three answers with similar meaning and one is different, the different answer is likely correct.
Life, health, and nursing rarely deal with certainties. You can usually eliminate answers with absolute wording, including:
Beware of red herrings! Sometimes an option will bring in an approach or body system that is unrelated to the question stem, and is very likely incorrect. For example, if the question asks about laboratory work but the answer explains correct client education for the disease process, you have to remember what the question is actually asking. If an answer seems random, it probably is.
The NCLEX is focused on textbook answers more than the sometimes messy realities of nursing life. Unless otherwise indicated, your answers should reflect thorough nursing practice under ideal conditions with ample time, staff, and resources.
If you’re really stuck on an NCLEX question, the process of elimination can increase your odds of making a more educated guess. Rule out obviously false answers before you close your eyes and click at random.
On the NCLEX, you will need to use critical thinking and clinical judgment to understand situations, apply your knowledge, and make decisions that align with nursing best practices. Because this exam is designed to measure the way you apply knowledge in realistic nursing problems, memorization is not the most effective technique for passing this exam.
Break down NCLEX questions to help you analyze and prioritize information and arrive at the best possible answers. Here are some specific critical thinking skills that will help you pass the NCLEX.
Misreading the question is one of the most common NCLEX pitfalls. Pay attention to the question’s wording and be clear on its intent before you even look at the answers. Then, pay close attention to each of the answers and their phrasing. It can also help to read through each NCLEX question more than once.
Finding patterns in NCLEX questions and answers can help you build mental connections and answer correctly. Look out for patterns, like groups of possible answers that mean the same or similar things, answers that address physiological versus psychosocial needs, or answers about assessing a situation versus implementing action.
Finding connections between situations is another critical thinking skill that will serve you on the NCLEX and during your nursing career. Successful nurses apply the knowledge they gain from one situation to other relevant circumstances, both during the NCLEX and in clinical practice.
There is another tool that can help you prioritize safety. When in doubt about how to help a client, remember to check their Airway, Breathing, and Circulation. Prioritizing safety and basic cares is another strategy to break down NCLEX questions. Client safety comes first. Here are some things to consider when choosing the safest course of action:
Keep an eye out for potential risks and complications that may arise from a client’s condition. The answer that best addresses risk and improves outcomes is likely correct.
Remember your Nursing ABCs.
You’ve taken the time to read, reread, and break down an NCLEX question. You understand its format, have identified key information, and analyzed the client scenario. You ruled out decoy answers, then used critical thinking and prioritized safety to come up with the best options. At some point you have to click on an answer.
Because the NCLEX is formatted to make you think, lots of candidates find themselves overthinking. It’s important that you make a decision, then don’t look back. Most of the time when you change your answer, you move from a correct to an incorrect answer.
Choose your answer, take a deep breath, and move onto the next question.
Read more about how to avoid overthinking the NCLEX.
The point of NCLEX practice tests isn’t to prove to yourself that you already know how to pass the exam. The point of practice tests is to learn how to take the NCLEX. Wrong answers on NCLEX practice questions can teach you just as much as correct ones if you review the answer rationales.
Because this exam is different from pretty much every other test you’ve taken, you need to learn to think like the NCLEX. Studying answer rationales on NCLEX practice questions will help you understand why the correct answer is right and why the incorrect options are wrong. This is one of the best ways to get NCLEX logic deep in your brain. Then, when it comes to test day, you won’t be blindsided by question formats or thinking exercises.
Nursing knowledge, great notes, and strategy only go so far. To pass the NCLEX, you’ll have to consistently practice breaking down NCLEX questions. Here are some NCLEX preparation tips:
You can find more NCLEX study tips in this blog post.