This article covers preparing for NCLEX, developing a study plan and what to expect. If you’re interested in learning specifically about the next gen NCLEX, then make sure you check out this article, too.  Listen to the below information on preparing for NCLEX in episode 217 of the Straight A Nursing podcast wherever you get your podcasts or straight from the website here.

The NCLEX step-by-step

Let’s go through the steps you need to take in order to take your licensing exam.

Step 1: Apply for licensure and registration through your state’s board of nursing. 

Step 2: Register for the exam on the Pearson VUE website using your school’s program code. Your school may provide this, but if not, it’s easy to locate online at the NCSBN website.

At this time you will also pay for your exam. At the time of this writing, the cost is $200 payable by credit card, prepaid card or debit card. Note there may be additional fees associated with your individual state.

Step 3: You’ll receive an acknowledgement of your registration to the email address you provided at registration – be sure to check your spam and promotions folders for an email from Pearson VUE. If you want to make sure their emails land in your inbox, you can create a rule that puts any email from that sender in your inbox, add them to your address book, or simply move any that do land in spam into your inbox.

Step 4: Your state board of nursing verifies your eligibility with Pearson Vue. This is dependent upon your school sending the board proof you have met all their requirements. 

Step 5: Wait patiently for your Authorization to Test (ATT). This will come in the form of an email from Pearson VUE, which is another reason to keep a close eye on your inbox. The timing on this can vary, but a good rule of thumb is that this email will arrive about two weeks AFTER your eligibility is verified. 

Step 6: Schedule your exam through Pearson VUE. Note that your test date must be within 90 days of receipt of your ATT. 

NCLEX Test Day

Your next step is to show up for your test! Be sure to bring the appropriate ID, eat a good breakfast and follow all the rules of the testing center (there are a lot!).

When you arrive, you’ll be asked to sign in and you’ll also have your photograph taken as well as be asked to provide a palm vein scan as an additional identifier. You’ll be required to store your electronics in a sealable plastic bag – this includes smart watches, phones, tablets, mp3 players, even fitness trackers…nothing digital goes in with you and this bag cannot be accessed at all during your breaks.

In addition, you’ll be provided a locker for your personal items and it’s best not to bring any test prep material or notes of any kind. During a break you will be able to access your bag or purse, food and drink, lip balm, medical devices and various other items (which you can view in the NCLEX candidate rules linked above).

You’ll be given a white board and marker before entering the room and earplugs are available upon request. Bringing in your own earplugs or wearing noise-canceling devices is not allowed.

You will also be given the opportunity to take two breaks. My advice is to take them even if you don’t need a break at that time. If nothing else, get up, stretch and take a few deep breaths while you rest your eyes (and your hard-working brain!). The first break occurs after approximately two hours and then again around 3.5 hours. A notification will come up on your screen at the appropriate time, so don’t worry about keeping an eye on the clock. 

It is important to note that the breaks DO count against your total testing time, so be efficient with whatever it is you need to do (get a snack, run to the bathroom, etc…).  You can also request a break at any time, but you must first raise your hand to get the attention of the TA. They will excuse you and you’ll have your palm scanned upon leaving and re-entering the testing room. And yes, you will be monitored by video and audio the entire time.

After the Test

After you complete your NCLEX, it’s time to celebrate and decompress! Take yourself out for a celebratory massage, lunch, double-shot venti mocha or get together with family/friends. It’s important to do something to mark the completion of this huge milestone!

And then, wait patiently for your official results – in some states unofficial results are available after 48 hours for a small additional fee which you pay at the time of registration. Note that it can take up to six weeks for your nursing regulatory body to send you your official results. Please do not waste your time, energy and emotional reserves on doing the “Pearson VUE trick.” This is an unreliable method and only adds to your stress. Take this time to turn your attention back to other areas of  your life and take care of yourself. You’ve worked really hard for years and, most likely, this hurdle is now behind you.

However, if you do not pass the exam, you will receive a candidate performance report which shows how you performed in each test area. This is your guide for preparing to retake your exam and you will need to wait at least 45 days to retake it.

If you have other questions or want to dive into more detail on the specifics of testing, I encourage you to visit the NCSBN website.

How to Prepare for NCLEX

So now that you know what the procedure looks like – you’re probably wanting to know how to prepare and develop a study plan.

The very first thing I recommend students do is go to the NCSBN website and check out their “test plan.” It’s absolutely free and tells you how the exam is structured and how the content is distributed. For example, psychosocial integrity makes up 6 to 12% of the exam, and questions about safety/infection control make up 9 to 15% of the exam. This can help give you an idea of how to focus your studying and what to expect.

The largest section of the exam is in management of care, which is about 20% of your exam – this includes topics like time management, supervising assistive personnel, managing conflict, prioritizing care, patient education, scope of practice and collaborating with other members of the interdisciplinary team.

When students begin studying for NCLEX, they often feel overwhelmed. You learned so much in nursing school…and now you’ve got to review all of it in order to pass NCLEX. It’s no wonder that it can feel a bit intimidating. A fantastic place to start is with an online test bank or an NCLEX prep book (#ad) (I’m a huge fan of the Saunders books).

As you go through practice questions, you will start to recognize patterns. Pay very close attention to these!

  • What types of questions do you struggle with? Maybe it’s the questions with a negative qualifier and you simply misread it. Maybe it’s SATA questions or questions where you prioritize a task or put things in a specific order. Knowing where you struggle alerts you to pay closer attention to those types of questions moving forward.
  • What content are you needing to brush up on? For me it was labor and delivery, mental health and neuro, so I spent a lot more time studying those subjects as I developed my personal NCLEX study plan.
  • You’ll also start to see some consistencies, especially around things like signs/symptoms and pharmacology. For example, so many times questions about digoxin and lithium have to do with toxicity, so by doing practice questions you’ll realize that you should know the signs/symptoms of lithium toxicity and digoxin toxicity. Other times, pharmacology questions will focus on adverse effects and you’ll see the same ones mentioned over and over again. For example, phenytoin causes gingival hyperplasia, beta blockers cause orthostatic hypotension, and furosemide is going to lead to hypokalemia. Make note of these consistencies as you go.
  • As you do practice questions, make sure you read the rationales even if you got the answer correct. You’ll learn so much by reading why the correct answers are correct and the wrong answers are wrong. As you come across these nuggets of knowledge, turn them into flashcards or simply jot them down in a notebook…and then review, review, review.

Creating your NCLEX study plan

When developing your NCLEX study plan, it’s important to take your schedule and other commitments into consideration. 

  • Make note of the date of your exam – most students who pass NCLEX study for 1 to 2 months. Anything shorter than that and you risk cramming, which we all know isn’t an effective way to study.
  • Look at your other commitments such as a job, your family’s needs, or that long-overdue vacation.
  • Determine which days of the week you can commit to studying and how many hours you’ll study on those days. The goal is to spread the content evenly so you’re not cramming at the last minute. 
  • Consider taking a comprehensive practice test to identify exactly which areas you need to focus on the most and dedicating more study time to those specific subjects. 
  • Mix up your study sessions so you stay engaged and motivated. Designate some sessions as review and other sessions to do practice questions. How you review material can be varied as well – in addition to using the Straight A Nursing podcast, you could read through the notes you took in nursing school, dust off your textbooks, and subscribe to a test prep program such as uWorld or Kaplan.

Make your study calendar

While the NCLEX is categorized into broad categories like “health promotion and maintenance” your NCLEX prep materials (and nursing school notes) are probably not categorized in that way. Most likely, the categories are more concrete and focus on specific topics such as respiratory, pharmacology, therapeutic communication, infection control and mental health. 

There are a couple of different options for how to organize your study schedule. You can focus your efforts on your weakest areas (ideal if you are crunched for time) or do a comprehensive review of all the major subjects. To focus on your weakest areas you’ll need to take a practice assessment that includes a comprehensive mix of topics. Curious what this looks like? I’ve got three sample study pathways you can download here. One is a 5-week plan that focuses on your weakest areas and a more comprehensive 8-week plan that goes through topics one at a time. There’s also a 3-week “cram plan” if you need it though it’s not ideal.

NCLEX Tips for Success

In addition to studying effectively and sticking to  your plan, here are a few tips that can you prepare for NCLEX success:

  • It’s never too early to start preparing for NCLEX since this is the format all your nursing school exams will be utilizing. Get a prep book such as Saunders and start using the practice questions in your very first semester of nursing school.
  • No studying late the night before or on test day! Go into the exam fresh and rested.
  • Make sure you read each question carefully – when you rush you risk skipping over key words and phrases.
  • Don’t read into the question or apply your “real-world” experience. Stick with what’s written and textbook knowledge.
  • Before looking at multiple choice options, try to state what you think the right answer is first. This gets you thinking about what you know about a topic. And, if that answer is listed, it’s very likely to be the ​​correct one.
  • Look for keywords like “first, best, priority.” The answer is usually the thing that will prevent the patient from imminent danger.
  • Also look for negative qualifiers like “except” or “least.” Along those same lines, some questions will ask you to choose the option that is the least correct, especially as it relates to patient education. For example, the question could say, “Which option indicates the patient with diabetes needs further teaching?” and then the answers would be three CORRECT things about diabetes and one that’s wrong…the wrong statement is the correct answer because that’s the one that indicates the patient needs further teaching. Read carefully!
  • Look for absolutes such as “always” and “never.” Most of the time, these are not going to be the correct options.
  • When looking at interventions, it’s usually best to choose the least invasive option that will still provide benefit first.
  • For priority questions, apply the ABCs, Maslow’s Hierarchy of Needs, and The Nursing Process.
  • Approach SATA (select-all-that-apply) questions as though each option is its own true or false question.

Tips for Different Learning Styles

  • Visual – A great resource for visual learners is Picmonic (#ad). Also, pay attention to charts, graphs, illustrations and photos in your notes and textbooks. Some visual learners do well with drawing pictures and creating concept maps, so if you’re a visual learner these are great methods for you to try.
  • Auditory – Picmonic and other video-based learning platforms are great for auditory learners as well. You’ll also benefit from listening to recorded information, which can be as simple as you reading through your notes. You’ll also do well with rhymes, mnemonic devices and stories. Many students utilize the Study Sesh podcast for dynamic review (learn more about Study Sesh here).
  • Reading/Writing – If you learn well by reading/writing, then it makes sense for you to read through  your notes or even key sections of your textbooks. For those more complex concepts, you’ll thrive by writing them out in your own words.
  • Kinesthetic – For hands-on learners, you’ll benefit by engaging in physical activity while you review…even just walking or tossing a ball against the wall while you listen to a recorded lesson can help make connections in your brain.

I hope this overview of prepping for your NCLEX helps you pass your exam the first time! I’m cheering for you!

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