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What's on the NCLEX-RN Exam?

NCLEX-RN - Content Overview

The NCLEX examination is designed to test virtually every aspect of patient care that a new nurse will face. In other words, it covers all of nursing school, if not more. Some questions are very specific and technical like the choosing the name of an anatomical location or calculating a drug dosage. Other questions test your knowledge of the processes of nursing, such as what the nurse should do in a certain scenario. This second type are usually not as clear cut and may require more thought.

The NCLEX determines if the nursing student has four things, and these are integrated throughout the entire exam:

Nursing Process - which is the medical technicalities of caring for a patient, basically, how well you can identify what the patient's medical needs are and administer the appropriate treatment.

Caring - The psychological side of being a nurse - how well you can promote respect and trust between you and the patient. This also includes concepts such as hope, compassion, and encouragement.

Communication and Documentation - How well you can communicate with the patient (verbal and nonverbal), the patient's family, and your medical colleagues. Also tests your ability to properly document the patient's info as required of a nurse.

Teaching/Learning - Your ability to teach the patient or patient's family the skills necessary to improve the patient's quality of life.

Culture and Spirituality (As of 4/1/16) – You ability to adjust the required nursing care to accommodate the patient's ethnicity, religious or spiritual needs, as well as other self identified preferences and needs.

Specific Topics on the Exam:

Safe and Effective Care Environment

Safe and effective care environment means that you'll be tested on the procedures and knowledge that safeguard the patient and staff in all aspects, in both a physical and non-physical manner. This sections is divided into two - the aspects of safety that are mainly non-physical (Management of Care) and the aspects that are mainly physical (Safety and Infection Control).

Management of Care (17-23%)

Deals mainly with the management of the nursing care, as opposed to the nursing care itself. For example, it will cover areas such as what info you can disclose about the patient and to whom. Who has the legal right to decide on the direction of treatment for the patient, including whether to keep them "plugged in". How well can you cooperate with the rest of the medical team. Supervision, such as how often to check on a certain kind of patient. How to prioritize which patients to take care of first. Also covers various nursing ethics.

Safety and Infection Control (9-15%)

Deals mainly with the prevention of physical harm to the patient and medical staff. For example, how to handle dangerous objects, such as sharp instruments,chemicals, syringes that contain disease, etc. It also tests you on knowing which changes in a patient must be reported to the doctor. Another focus is on safe use of equipment, such as x-ray equipment. You are also tested on the proper use of restraints and safety devices, and ergonomic safety, such as the proper use of crutches. Home safety is also included in this section.

Health Promotion and Maintenance (6-12%)

This section tests you on the the strategies for maintaining health and achieving optimal health. The examinee must understand the varying health needs of a person from the fetus stage all the way to old age, including mental health. It also tests you on detection of disease, such as how often to see a doctor, when to start screening for a particular disease, etc. Another focus is on prevention, such as dealing with behaviors that pose a health risk: smoking, alcoholism,drug abuse, etc. Weight loss topics are in this part as well.

Psychosocial Integrity (6-12%)

Deals with the psychological and social side of nursing, such as giving support and compassion to patients or their families who are undergoing stressful events, or how to react to patients with psychological disorders.This encompasses subjects such as stress management, coping mechanisms, grieving, victims of abuse or neglect, and dealing with various types of addicts. You must also understand the effect of culture and religion on the patient's needs.

Physiological Integrity

This section deals with many of the nuts and bolts of caring for the patient.

Basic Care and Comfort (6-12%)

Questions in this section assess whether the nurse can provide care to patients in their activities of daily living. This includes subjects such as feeding, sleep, hygiene, removing waste, assistive devices such as hearing aids or fake limbs, orthopedic devices such as splints or casts, and general patient mobility.

Pharmacological and Parenteral Therapies (12-18%)

Pharmacological therapy refers to any therapy that involves medication. Parenteral therapy refers to therapy that is *not* administered by mouth, such as IV therapy. This section requires you to make judgments about which medications are appropriate, and how to calculate the dosage. You must also be able to evaluate the effects that the medication had on the patient. It also requires you to know how to give medication or feeding through the blood. This is one of the tougher sections on the NCLEX-RN.

Reduction of Risk Potential (9-15%)

Reduction of Risk Potential refers to reducing the possibility of complications from a disease or a treatment. No disease has just one symptom or consequence, and no treatment is without the possibility of a side effect. For example, long term, poorly controlled diabetes can lead to retinal damage, kidney damage, and neuropathy. It also requires understanding the possible side-effects of a drug. For example, a patient with diabetes that is prescribed a corticosteroid will likely experience an increase in their blood sugar. This section also includes questions on monitoring vital signs (such as temperature and blood pressure) and understanding blood values (such as cholesterol and glucose).

Physiological Adaptation (11-17%)

This section deals with critical care, which means care for life threatening situations. It also includes emergency care, and care for patients with chronic (long-lasting) conditions, such as diabetes, kidney failure, or emphysema. This test section contains the dreaded acid-base disturbance questions, common problems in patients requiring a ventilator. Also in this section is treating wounds and the treatment of patients after surgery.

NCLEX-RN Question Types

Multiple Response

Like mult choice, but May have more than one answer, student must find all to get correct.


Will have to calculate an answer and input it - no possible answers are provided. You will have access to a calculator for these questions.

Hot Spot

You will be shown a diagram of something (such as a part of the body), and you'll be asked to click on the area referred to by the question.


You'll be shown data in a chart or a table, and asked a multiple choice question based on it.

Ordered Response

You must drag and drop items into the correct order. For example, the order in which certain nursing procedures are done.


Multiple choice, but questions is a sound, such as a heartbeat. (you are provided headphones)

Graphic Options

Multiple choice, but answers are graphics instead of words.