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10 NCLEX Tips to Boost Your Exam Performance

You know how important the NCLEX is, that’s why you’re here. Whether you’ve just begun to prepare for the big day or you’re several practice tests in, our goal is to help you make the most out of your study sessions.

Remember, no one ever said they didn’t pass a test because they practiced too much. And the NCLEX is not something you prepare for a few days before you take it. You’ll need an arsenal of tips like the ones that follow to help you best prepare, AND pass, the NCLEX with ease.

1. Simplify the question by removing distractors. Some questions are wordy and provide too much information, making it seem more confusing than it actually is. For example:

A newly diagnosed 8-year-old child with type I diabetes mellitus and his mother are receiving diabetes education prior to discharge. The physician has prescribed Glucagon for emergency use. The mother asks about the purpose of this medication. Which of the following statements by the nurse is correct?

A. Glucagon enhances the effect of insulin in case the blood sugar remains high one hour after injection.

B. Glucagon treats hypoglycemia resulting from insulin overdose.

C. Glucagon treats lipoatrophy from insulin injections.

D. Glucagon prolongs the effect of insulin, allowing fewer injections.

You can simplify this question to, “What is the purpose of Glucagon?” You’ll have an easier time choosing the correct answer, “B. Glucagon treats hypoglycemia resulting from insulin overdose” by getting to the meat of the problem.

2. Brush up on your medical prefixes, suffixes, and root words. Let’s say you’re asked about a medical condition like, “What symptoms should the nurse expect to see in a patient with acute glomerulonephritis? Select all that apply” but you can’t for the life of you remember what glomerulonephritis is. Try breaking apart the word:

glomerulo + nephr + itis

Maybe you can’t figure out or remember what “glomerulo” represents (answer: glomerulus - a cluster of capillaries around the end of a kidney tubule), and that’s okay because you do know that “nephr” or “nephro” always refers to kidneys and that “itis” indicates an inflammatory disease. You now know that you have a better chance of answering the question correctly if you select the answers that correspond to kidney inflammation. Even without knowing the first part of the word, you’re able to make an educated guess based on the rest of the word.

3. Reach out to other students and nurses. Sometimes the best advice comes from your peers, so who better to ask than your fellow classmates and other registered nurses? By asking your peers for their advice and support, you’re not only learning something, but you might also create a study group out of it! Study groups are a great way to accelerate your learning. You can also organize an online study group if you’re unable to meet up with classmates.

4. Be ready for the “select-all-that-apply” questions. Remember it’s, select all that apply! It may seem like an obvious statement, yet it’s the reason why so many struggle with those questions. Don’t worry about whether you’re selecting too many or too few of the available answers, instead apply each possible answer to the question as though it were a true/false statement. For example:

By turning each available answer into a true/false question, you can determine that 1 and 2 do not apply because the nurse would monitor vital signs every 30-60 minutes, and notify the physician at 12 or fewer respirations per minute.

A nurse would perform interventions 3-7 because it allows them to determine if or when the client’s magnesium levels became toxic.

Monitor renal function and cardiac function closely” - Magnesium sulfate toxicity can cause the nervous system and cardiac and renal functions to slow down.

Keep calcium gluconate on hand in case of a magnesium sulfate overdose” - Calcium gluconate is the antidote for magnesium sulfate toxicity.

Monitor deep tendon reflexes hourly” - Similar to cardiac and renal functions, the client’s deep tendon reflexes may slow down or disappear if they are receiving a toxic level of magnesium sulfate.

Monitor I’s and O’s hourly” - This is to ensure that the client’s body is eliminating the medication properly so as to avoid magnesium sulfate toxicity.

Notify the physician if urinary output is less than 30 ml per hour” - The medication will be eliminated through the kidneys. If the client’s urinary output is less than 30 ml per hour, then they are at risk or already have magnesium sulfate toxicity. A physician can assess the patient and determine the best course of action to try to correct the issue.

While these “select all that apply” questions can be tricky, they’re generally a sign that you are doing well in that category.

5. Put the patient first. The NCLEX (including practice tests) will present you with a plethora of scenarios and have you choose the best course of action to take. Nine times out of ten, the correct answer is the one that is best for the patient and NOT easiest for the nurse.

The NCLEX is a patient/client-centered test. In an ideal world, you will always be able to do what’s best for the patient. Having said that, you’ll come across scenarios in real life (and possibly on the exam) where you can’t or shouldn’t do what’s best for the patient:

Patient’s Religious Beliefs - Ultimately as a nurse, it would be unethical, and illegal, for you to do anything that the patient does not consent to. For example, your patient has lost a lot of blood and the best course of action for their wellbeing would be to administer a blood transfusion. Due to the patient’s or patient’s family’s (if the patient is a minor and/or unconscious) religious beliefs, you or the physician may not be able to give the patient the blood transfusion even though, medically speaking, it is what is best for them.

Safety Concerns - If the nurse is in physical danger from a patient’s behaviors or actions, it is necessary for the nurse to call for assistance in de-escalating the situation before physical or chemical restraints become necessary. Remember, restraining a patient is the last resort in behavioral management and is used only when necessary in preventing harm.

Generally speaking, the NCLEX is looking to make sure that you put safety first whenever possible by promoting health, wellbeing, and an environment free of risks to yourself and others.

6. Start studying long before the day of your test. Like I mentioned at the beginning of this post, you can’t cram for the NCLEX with only days before you’re supposed to take it. By studying for this exam at least three months ahead of time, you’re able to work on subjects you struggled with during your nursing education, stay fresh with areas that you’re comfortable with, and get used to how the test is formatted.

Half of the reason why studying for months at a time and taking practice tests are emphasized so much is so that you can understand and become comfortable with how questions are delivered and with taking a test for two-three hours at a time (you have six hours to complete the test, but breaks are given about every two hours). You’ll be happy you gave yourself those months of studying when you know what to expect on the NCLEX and pass it.

7. Brush up on your medication calculation rules and formulas. You’ll need to know this stuff, and know it well. These questions are fill-in-the-blanks and will require you to know complex dosage calculations. You can use a calculator, so don’t forget it on the day of the test! There are many online resources available to help you brush you on your math, along with sample questions to help you study. You’ll also need to brush up on your metric conversions as well as IV infusion rate calculations.

8. Look for the odd answer. If you get stumped by a question, it sometimes feels like you can do no better than guess. But if you’re really struggling with a multiple-choice question and want to avoid the guessing game, look for the odd answer. If you can group three out of the four choices together, the remaining one (the distractor) is likely the correct answer. This doesn’t always work, but if you’re in a jam and don’t know what to do, give this trick a try. For example, if all choices but one are stated in kilograms and the exception reads “15 oz,” that choice might be the answer. This is a tried and true trick that can be applied to virtually any test you take, including the NCLEX.

9. Visualize the situation or problem in the question. If the question pertains to an actual work situation, envision the scenario and how you would handle it. Put yourself in the mindset of a nurse and apply what you know. For example, form a mental image of what flexion looks like versus extension, how you would handle a patient hospitalized with COPD, or dressing a wound with a drain. Let’s take a look at how visualization can help you answer a type of question that may appear on the NCLEX exam:

A nurse is caring for a geriatric client after a sigmoidoscopy. If the client exhibits any of these symptoms an hour after the procedure, which one would the nurse be MOST concerned aboutê?

A. The client has mild pain and cramping in the abdomen.

B. The client reports fullness and pressure in the abdomen.

C. The client appears groggy and is thirsty.

D. The client is lightheaded and dizzy.

Picture yourself in the room with this client. You see that they are a bit groggy, and they ask for a glass of water. Considering that they recently woke up from surgery, this is perfectly normal behavior. You ask how they are feeling and the client tells you that their abdomen hurts, which is no surprise to you considering the type of surgery they just had. Then the client tries to move, and you notice that they seem lightheaded and dizzy. THIS is your red flag because it could signify bowel perforation causing hypovolemic shock, and you should inform the physician immediately.

By visualizing the situation as the RN, you may have an easier time decide on the best course of action. At the very least you’re doing the exact thing that NCLEX is testing you on, which is using critical thinking to apply what you have learned to real-life scenarios.

10. Breathe, relax, and stay calm. Yes, you need to pass the NCLEX to become a nurse, and the ultimate goal of this test is to make sure that you are ready to be a “real” nurse. Being a nurse is all about staying relaxed, calm, and focused under pressure. So take a deep breath, you’re studying and you’ve got this.


J. Bass was the administrator and editor of a website dedicated to helping nurses advance their careers and education. She wrote student-focused articles on a variety of academic- and career-related topics in the nursing and healthcare fields.