Master the NCLEX-RN Exam (2022)
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MASTER THE™ NCLEX-RN®
1ST EDITION
1ST EDITION
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About Peterson’s®
Peterson’s has been your trusted educational publisher for over 50 years. It’s a milestone we’re quite proud
of, as we continue to offer the most accurate, dependable, high-quality educational content in the field,
providing you with everything you need to succeed. No matter where you are on your academic or
professional path, you can rely on Peterson’s for its books, online information, expert test-prep tools, the
most up-to-date education exploration data, and the highest quality career success resources—everything
you need to achieve your education goals. For our complete line of products, visit www.petersons.com.
For more information, contact Peterson’s, 8740 Lucent Blvd., Suite 400, Highlands Ranch, CO 80129, or
find us online at www.petersons.com.
NCLEX®, NCLEX-RN®, and NCSBN® are registered trademarks of the National Council of State Boards of
Nursing, Inc. (NCSBN), which did not collaborate in the development of, and does not endorse, this
product.
© 2019 Peterson’s®
ALL RIGHTS RESERVED. No part of this work covered by the copyright herein may be reproduced or
used in any form or by any means—graphic, electronic, or mechanical, including photocopying, recording,
taping, Web distribution, or information storage and retrieval systems—without the prior written permission
of the publisher.
For permission to use material from this text or product, complete the Permission Request Form at
www.petersonspublishing.com/spa/permissions.aspx.
ISBN: 978-0-7689-4366-5
Printed in the United States of America
10 9 8 7 6 5 4 3 2 21 20 19
First Edition
Peterson’s has been your trusted educational publisher for over 50 years. It’s a milestone we’re quite proud
of, as we continue to offer the most accurate, dependable, high-quality educational content in the field,
providing you with everything you need to succeed. No matter where you are on your academic or
professional path, you can rely on Peterson’s for its books, online information, expert test-prep tools, the
most up-to-date education exploration data, and the highest quality career success resources—everything
you need to achieve your education goals. For our complete line of products, visit www.petersons.com.
For more information, contact Peterson’s, 8740 Lucent Blvd., Suite 400, Highlands Ranch, CO 80129, or
find us online at www.petersons.com.
NCLEX®, NCLEX-RN®, and NCSBN® are registered trademarks of the National Council of State Boards of
Nursing, Inc. (NCSBN), which did not collaborate in the development of, and does not endorse, this
product.
© 2019 Peterson’s®
ALL RIGHTS RESERVED. No part of this work covered by the copyright herein may be reproduced or
used in any form or by any means—graphic, electronic, or mechanical, including photocopying, recording,
taping, Web distribution, or information storage and retrieval systems—without the prior written permission
of the publisher.
For permission to use material from this text or product, complete the Permission Request Form at
www.petersonspublishing.com/spa/permissions.aspx.
ISBN: 978-0-7689-4366-5
Printed in the United States of America
10 9 8 7 6 5 4 3 2 21 20 19
First Edition
Loading page 5...
Peterson’s Updates
Check out our website at www.petersonspublishing.com/publishingupdates to see if there
is any new information regarding the test and any revisions or corrections to the content of
this book. We’ve made sure the information in this book is accurate and up to date; however,
the test format or content may have changed since the time of publication.
Check out our website at www.petersonspublishing.com/publishingupdates to see if there
is any new information regarding the test and any revisions or corrections to the content of
this book. We’ve made sure the information in this book is accurate and up to date; however,
the test format or content may have changed since the time of publication.
Loading page 6...
Contents
Before You Begin
Who Should Use This Book?
How This Book Is Organized
How to Use This Book
Special Study Features
Proven Strategies to Raise Your Score
Give Us Your Feedback
You’re Well on Your Way to Success!
PART I: THE REGISTERED NURSING PROFESSION AND THE
NCLEX-RN®
1 About the RN Profession and the NCLEX-RN®
Overview
Registered Nurses and Their Career Outlook
Nursing Education
Licensure
NCLEX-RN® Exam Basics
Proven Test-Taking Strategies and Study Techniques
NCLEX-RN® Test Plan
Top 10 Strategies for Choosing the Correct Answer
Summing It Up
PART II: DIAGNOSING STRENGTHS AND WEAKNESSES
2 Practice Test 1: Diagnostic Test
Answer Sheet
Answer Key and Explanations
Diagnostic Test Assessment Grid
PART III: NCLEX-RN® REVIEW
3 Safe and Effective Care Environment
Overview
Client Needs for Management of Care
Case Management
Client Rights
Concepts of Management
Information Security and Confidentiality
Legal Rights and Responsibilities
Client Needs for Safety and Infection Control
Handling Hazardous and Infectious Materials
Reporting of Incident/Event/Irregular Occurrence/Variance
Safe Use of Equipment
Home Safety
Summing It Up
Practice Questions: Safe and Effective Care Environment
Answer Key and Explanations
4 Health Promotion and Maintenance
Overview
The Aging Process
Ante/Intra/Postpartum and Newborn Care
Developmental Stages and Transitions
Health Promotion/Disease Prevention
Health Screening
High-Risk Behaviors
Lifestyle Choices
Self-Care
Before You Begin
Who Should Use This Book?
How This Book Is Organized
How to Use This Book
Special Study Features
Proven Strategies to Raise Your Score
Give Us Your Feedback
You’re Well on Your Way to Success!
PART I: THE REGISTERED NURSING PROFESSION AND THE
NCLEX-RN®
1 About the RN Profession and the NCLEX-RN®
Overview
Registered Nurses and Their Career Outlook
Nursing Education
Licensure
NCLEX-RN® Exam Basics
Proven Test-Taking Strategies and Study Techniques
NCLEX-RN® Test Plan
Top 10 Strategies for Choosing the Correct Answer
Summing It Up
PART II: DIAGNOSING STRENGTHS AND WEAKNESSES
2 Practice Test 1: Diagnostic Test
Answer Sheet
Answer Key and Explanations
Diagnostic Test Assessment Grid
PART III: NCLEX-RN® REVIEW
3 Safe and Effective Care Environment
Overview
Client Needs for Management of Care
Case Management
Client Rights
Concepts of Management
Information Security and Confidentiality
Legal Rights and Responsibilities
Client Needs for Safety and Infection Control
Handling Hazardous and Infectious Materials
Reporting of Incident/Event/Irregular Occurrence/Variance
Safe Use of Equipment
Home Safety
Summing It Up
Practice Questions: Safe and Effective Care Environment
Answer Key and Explanations
4 Health Promotion and Maintenance
Overview
The Aging Process
Ante/Intra/Postpartum and Newborn Care
Developmental Stages and Transitions
Health Promotion/Disease Prevention
Health Screening
High-Risk Behaviors
Lifestyle Choices
Self-Care
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Techniques of Physical Assessment
Summing It Up
Practice Questions: Health Promotion and Maintenance
Answer Key and Explanations
5 Psychosocial Integrity
Overview
Abuse and Neglect
Behavioral Interventions
Coping Mechanisms
Crisis Intervention
Cultural Awareness/Cultural Influences on Health
End-of-Life Care
Family Dynamics
Grief and Loss
Mental Health Concepts
Religious and Spiritual Influences on Health
Sensory/Perceptual Alterations
Stress Management
Substance Use and Other Disorders and Dependencies
Support Systems
Therapeutic Communication
Therapeutic Environment
Summing It Up
Practice Questions: Psychosocial Integrity
Answer Key and Explanations
6 Physiological Integrity
Overview
Client Needs for Basic Care and Comfort
Assistive Devices
Elimination
Mobility/Immobility
Nonpharmacological Comfort Interventions
Nutrition and Oral Hydration
Personal Hygiene, Rest, and Sleep
Client Needs for Pharmacological and Parenteral Therapies
Contraindications, Interactions, Side Effects, and Adverse Effects
Dosage Calculation
Medication Administration
Total Parenteral Nutrition (TPN)
Pharmacological Pain Management
Client Needs for Reduction of Risk Potential
Monitoring Changes in Client Condition
Diagnostic Tests and Laboratory Values
Potential for Alterations in Body Systems
Potential Complications from Diagnostic Tests, Treatments, and Procedures
Potential Complications from Surgical Procedures and Health Alterations
System-Specific Assessments and Therapeutic Procedures
Client Needs for Physiological Adaptation
Alterations in Body Systems
Fluid and Electrolyte Imbalances
Hemodynamics
Illness Management
Pathophysiology and Medical Emergencies
Summing It Up
Practice Questions: Physiological Integrity
Answer Key and Explanations
PART IV: PRACTICE TESTS
Practice Test 2
Answer Sheet
Answer Key and Explanations
Practice Test 3
Answer Sheet
Answer Key and Explanations
Summing It Up
Practice Questions: Health Promotion and Maintenance
Answer Key and Explanations
5 Psychosocial Integrity
Overview
Abuse and Neglect
Behavioral Interventions
Coping Mechanisms
Crisis Intervention
Cultural Awareness/Cultural Influences on Health
End-of-Life Care
Family Dynamics
Grief and Loss
Mental Health Concepts
Religious and Spiritual Influences on Health
Sensory/Perceptual Alterations
Stress Management
Substance Use and Other Disorders and Dependencies
Support Systems
Therapeutic Communication
Therapeutic Environment
Summing It Up
Practice Questions: Psychosocial Integrity
Answer Key and Explanations
6 Physiological Integrity
Overview
Client Needs for Basic Care and Comfort
Assistive Devices
Elimination
Mobility/Immobility
Nonpharmacological Comfort Interventions
Nutrition and Oral Hydration
Personal Hygiene, Rest, and Sleep
Client Needs for Pharmacological and Parenteral Therapies
Contraindications, Interactions, Side Effects, and Adverse Effects
Dosage Calculation
Medication Administration
Total Parenteral Nutrition (TPN)
Pharmacological Pain Management
Client Needs for Reduction of Risk Potential
Monitoring Changes in Client Condition
Diagnostic Tests and Laboratory Values
Potential for Alterations in Body Systems
Potential Complications from Diagnostic Tests, Treatments, and Procedures
Potential Complications from Surgical Procedures and Health Alterations
System-Specific Assessments and Therapeutic Procedures
Client Needs for Physiological Adaptation
Alterations in Body Systems
Fluid and Electrolyte Imbalances
Hemodynamics
Illness Management
Pathophysiology and Medical Emergencies
Summing It Up
Practice Questions: Physiological Integrity
Answer Key and Explanations
PART IV: PRACTICE TESTS
Practice Test 2
Answer Sheet
Answer Key and Explanations
Practice Test 3
Answer Sheet
Answer Key and Explanations
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PART V: APPENDICES
A State Boards of Nursing
B Nursing Organizations
C Websites of Interest
A State Boards of Nursing
B Nursing Organizations
C Websites of Interest
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Before You Begin
Peterson’s Master the™ NCLEX-RN® is written for candidates hoping to pass the NCLEX-RN
examination, given by National Council of State Boards of Nursing, Inc. (NCSBN®). This book
gives you the most thorough review and test-like practice available, covering all the categories
and subcategories tested on the exam.
WHO SHOULD USE THIS BOOK?
Peterson’s Master the™ NCLEX-RN® is perfect for nurses who have six months or less of nursing
experience and are interested in preparing to become a registered nurse. Use this book if you can
answer “yes” to the following statements:
• You want to prepare on your own time and at your own pace, but you don’t have time
for a preparation program that takes weeks to complete.
• You want a guide that covers all the key points you need to know but doesn’t waste time
on topics you don’t absolutely have to know for the exam.
• You want to avoid taking risks with this all-important exam by relying on “beat the
system” guides that are long on promises but short on substance.
• You want a collection of practice NCLEX-RN exams that look like the tests you will
actually take to pass the exam.
Peterson’s Master the™ NCLEX-RN® is written for candidates hoping to pass the NCLEX-RN
examination, given by National Council of State Boards of Nursing, Inc. (NCSBN®). This book
gives you the most thorough review and test-like practice available, covering all the categories
and subcategories tested on the exam.
WHO SHOULD USE THIS BOOK?
Peterson’s Master the™ NCLEX-RN® is perfect for nurses who have six months or less of nursing
experience and are interested in preparing to become a registered nurse. Use this book if you can
answer “yes” to the following statements:
• You want to prepare on your own time and at your own pace, but you don’t have time
for a preparation program that takes weeks to complete.
• You want a guide that covers all the key points you need to know but doesn’t waste time
on topics you don’t absolutely have to know for the exam.
• You want to avoid taking risks with this all-important exam by relying on “beat the
system” guides that are long on promises but short on substance.
• You want a collection of practice NCLEX-RN exams that look like the tests you will
actually take to pass the exam.
Loading page 10...
HOW THIS BOOK IS ORGANIZED
Peterson’s Master the™ NCLEX-RN® is divided into four parts to help you understand the role
of the registered nurse, the structure of the NCLEX-RN, and what you need to know to pass the
NCLEX-RN examination and obtain licensure. Full-length practice tests are included to help test
your knowledge and provide a basis for creating a study plan.
Part I (Chapter 1) gives you a quick overview of the important facts you need to know about
the registered nurse profession, the current NCLEX-RN Test Plan, and the computer-adaptive
testing environment.
Part II (Chapter 2) provides the first full-length practice test, a diagnostic test designed to help
you identify those areas where you need to spend more time in your review sessions.
Part III (Chapters 3–6) reviews the following Client Needs categories and subcategories found
on the current NCLEX-RN Test Plan:
1. Safe and Effective Care Environment
Management of Care
Safety and Infection Control
2. Health Promotion and Maintenance
3. Psychosocial Integrity
4. Physiological Integrity
Basic Care and Comfort
Pharmacological and Parenteral Therapies
Reduction of Risk Potential
Physiological Adaptation
Part IV (Practice Tests 2 and 3) includes two full-length practice tests that simulate the actual
exam, so you’re fully prepared for test day.
Part V (Appendix A–C) provides supplemental information on state boards of nursing and
professional organizations, as well as websites you can check for health, education, and job
information.
Peterson’s Master the™ NCLEX-RN® is divided into four parts to help you understand the role
of the registered nurse, the structure of the NCLEX-RN, and what you need to know to pass the
NCLEX-RN examination and obtain licensure. Full-length practice tests are included to help test
your knowledge and provide a basis for creating a study plan.
Part I (Chapter 1) gives you a quick overview of the important facts you need to know about
the registered nurse profession, the current NCLEX-RN Test Plan, and the computer-adaptive
testing environment.
Part II (Chapter 2) provides the first full-length practice test, a diagnostic test designed to help
you identify those areas where you need to spend more time in your review sessions.
Part III (Chapters 3–6) reviews the following Client Needs categories and subcategories found
on the current NCLEX-RN Test Plan:
1. Safe and Effective Care Environment
Management of Care
Safety and Infection Control
2. Health Promotion and Maintenance
3. Psychosocial Integrity
4. Physiological Integrity
Basic Care and Comfort
Pharmacological and Parenteral Therapies
Reduction of Risk Potential
Physiological Adaptation
Part IV (Practice Tests 2 and 3) includes two full-length practice tests that simulate the actual
exam, so you’re fully prepared for test day.
Part V (Appendix A–C) provides supplemental information on state boards of nursing and
professional organizations, as well as websites you can check for health, education, and job
information.
Loading page 11...
HOW TO USE THIS BOOK
Review Part I to familiarize yourself with the registered nurse profession, the array of career
opportunities, and the career outlook. Part I will also provide you with the opportunity to review
the NCLEX-RN Test Plan. Proven test-taking strategies and study techniques are provided along
with our top 10 strategies for choosing the correct answer.
Take the Diagnostic Test in Part II. This full-length test is designed to replicate the types of
questions you will find on the actual NCLEX-RN. We’ve provided detailed answer explanations
for all answer choices so that you can review why an answer was correct or not correct. Utilize the
Diagnostic Test Assessment Grid at the end of the chapter to help pinpoint what you know—
and what you don’t know. Your results provide you with a starting point to tailor your study plan.
Review the chapters in Part III. Each review chapter covers one of the client needs categories
and its sub-categories in depth, reviewing all the major concepts you will need to know to pass the
NCLEX-RN. Before you dive into a chapter, skim the bulleted overview, which lists the topics
covered in the chapter. The overview will allow you to quickly target the areas in which you are
most interested. At the end of every review chapter, you will find 10 practice questions along
with detailed answer explanations. Use these questions to test your understanding and further
assess where you will need to focus your study plan.
Take the practice tests in Part IV under test-like conditions. As you finish each practice test,
check your answers against the answer keys and read the explanation for each question you
missed. If you have the time, read all the answer explanations—they’re great for more in-depth
NCLEX-RN review. You can use your results from these practice tests to identify your strengths
and weaknesses, and then spend the rest of your time leading up to your exam reviewing the areas
where you need the most improvement.
Reference the supplemental material in Part V as needed for more information on professional
organizations and helpful websites to enhance your learning experience and expand your
knowledge base.
Print or Online? You Decide!
In addition to the two online tests that are included with the purchase of this book, Peterson’s
now gives you the option to take the diagnostic and practice tests in Peterson’s Master the™
NCLEX-RN® either on paper or online. Choose how you want to take them: on paper for
a more traditional study approach, or online to simulate the actual NCLEX-RN test-taking
experience, with automated timing, instant feedback, and scoring results. Take all the tests on
paper, all online, or in a combination of the two. The choice is yours.
To access your free online tests, visit the following URL:
www.petersons.com/testprep/nclex/
Add the NCLEX-RN Online Companion to your cart and enter the coupon code NCLEX1 at
checkout.
Review Part I to familiarize yourself with the registered nurse profession, the array of career
opportunities, and the career outlook. Part I will also provide you with the opportunity to review
the NCLEX-RN Test Plan. Proven test-taking strategies and study techniques are provided along
with our top 10 strategies for choosing the correct answer.
Take the Diagnostic Test in Part II. This full-length test is designed to replicate the types of
questions you will find on the actual NCLEX-RN. We’ve provided detailed answer explanations
for all answer choices so that you can review why an answer was correct or not correct. Utilize the
Diagnostic Test Assessment Grid at the end of the chapter to help pinpoint what you know—
and what you don’t know. Your results provide you with a starting point to tailor your study plan.
Review the chapters in Part III. Each review chapter covers one of the client needs categories
and its sub-categories in depth, reviewing all the major concepts you will need to know to pass the
NCLEX-RN. Before you dive into a chapter, skim the bulleted overview, which lists the topics
covered in the chapter. The overview will allow you to quickly target the areas in which you are
most interested. At the end of every review chapter, you will find 10 practice questions along
with detailed answer explanations. Use these questions to test your understanding and further
assess where you will need to focus your study plan.
Take the practice tests in Part IV under test-like conditions. As you finish each practice test,
check your answers against the answer keys and read the explanation for each question you
missed. If you have the time, read all the answer explanations—they’re great for more in-depth
NCLEX-RN review. You can use your results from these practice tests to identify your strengths
and weaknesses, and then spend the rest of your time leading up to your exam reviewing the areas
where you need the most improvement.
Reference the supplemental material in Part V as needed for more information on professional
organizations and helpful websites to enhance your learning experience and expand your
knowledge base.
Print or Online? You Decide!
In addition to the two online tests that are included with the purchase of this book, Peterson’s
now gives you the option to take the diagnostic and practice tests in Peterson’s Master the™
NCLEX-RN® either on paper or online. Choose how you want to take them: on paper for
a more traditional study approach, or online to simulate the actual NCLEX-RN test-taking
experience, with automated timing, instant feedback, and scoring results. Take all the tests on
paper, all online, or in a combination of the two. The choice is yours.
To access your free online tests, visit the following URL:
www.petersons.com/testprep/nclex/
Add the NCLEX-RN Online Companion to your cart and enter the coupon code NCLEX1 at
checkout.
Loading page 12...
SPECIAL STUDY FEATURES
Master the™ NCLEX-RN® is designed to be as user-friendly as it is complete. To this end, it
includes several features to make your preparation more efficient.
Overview
Each chapter begins with a bulleted overview listing the topics that are covered in the chapter.
This will allow you to quickly target the areas in which you are most interested.
Summing It Up
Each review chapter ends with a point-by-point summary that captures the most important
information in the chapter. The summaries are a convenient way to review the main points one
last time before the exam.
Notes and Tips
As you make your way through this guide, be on the lookout for the NOTE and TIP boxes. This
bonus information is designed to draw your attention to valuable concepts and test-taking advice,
as well as to highlight vital details about the NCLEX-RN exam format.
PROVEN STRATEGIES TO RAISE YOUR SCORE
In taking the NCLEX-RN exam, some strategies are more useful than others. The following
tips will help you pass the exam.
1. Create a study plan and stick to it. The right study plan will help you get the most out
of this book in the time that you have.
2. Review key test elements daily for several weeks before the exam. Reread the Test
Plan to be sure that you understand the categories and subcategories, and reread the
information about alternate test formats.
3. Complete all the exercises in this book. Doing so will help you recognize your areas
of strength and discover which areas need improvement.
4. If possible, visit the test center before the day of the exam. This will help you
become familiar with the location and how long it takes to travel there. On the day of
the exam, leave plenty of time to get to the test center in case the
buses/subways/trains are running late, the weather is bad, or parking your car is a
problem.
5. Avoid cramming the night before the exam. This will only make you feel more
nervous. It is not likely to help you learn enough to make a difference on your test
score.
6. Relax the night before the test. Try to take your mind off the exam for a while. Go to
a movie or hang out with a friend—but not with someone who will be taking the test
with you.
7. Be sure to bring one acceptable form of identification to the test center. You will not
be able to take the exam without the proper form of identification, and you will have
to reregister and pay another examination fee.
8. Listen to what the test administrator tells you and pay attention to the tutorial. Don’t
worry, though, because you don’t need to be a computer whiz to take the test.
9. Read every word of every question on the exam. Pay attention to details. They
provide clues and help prevent you from selecting the wrong answer choice.
10. Don’t spend too much time on any one question. You have up to six hours to
complete your exam—but you still can’t afford to spend too much time on any one
question. Try to maintain a steady pace. Due to the computer-adaptive nature of the
exam, it is more important to get the questions right so the exam is accurately
assessing your abilities.
Master the™ NCLEX-RN® is designed to be as user-friendly as it is complete. To this end, it
includes several features to make your preparation more efficient.
Overview
Each chapter begins with a bulleted overview listing the topics that are covered in the chapter.
This will allow you to quickly target the areas in which you are most interested.
Summing It Up
Each review chapter ends with a point-by-point summary that captures the most important
information in the chapter. The summaries are a convenient way to review the main points one
last time before the exam.
Notes and Tips
As you make your way through this guide, be on the lookout for the NOTE and TIP boxes. This
bonus information is designed to draw your attention to valuable concepts and test-taking advice,
as well as to highlight vital details about the NCLEX-RN exam format.
PROVEN STRATEGIES TO RAISE YOUR SCORE
In taking the NCLEX-RN exam, some strategies are more useful than others. The following
tips will help you pass the exam.
1. Create a study plan and stick to it. The right study plan will help you get the most out
of this book in the time that you have.
2. Review key test elements daily for several weeks before the exam. Reread the Test
Plan to be sure that you understand the categories and subcategories, and reread the
information about alternate test formats.
3. Complete all the exercises in this book. Doing so will help you recognize your areas
of strength and discover which areas need improvement.
4. If possible, visit the test center before the day of the exam. This will help you
become familiar with the location and how long it takes to travel there. On the day of
the exam, leave plenty of time to get to the test center in case the
buses/subways/trains are running late, the weather is bad, or parking your car is a
problem.
5. Avoid cramming the night before the exam. This will only make you feel more
nervous. It is not likely to help you learn enough to make a difference on your test
score.
6. Relax the night before the test. Try to take your mind off the exam for a while. Go to
a movie or hang out with a friend—but not with someone who will be taking the test
with you.
7. Be sure to bring one acceptable form of identification to the test center. You will not
be able to take the exam without the proper form of identification, and you will have
to reregister and pay another examination fee.
8. Listen to what the test administrator tells you and pay attention to the tutorial. Don’t
worry, though, because you don’t need to be a computer whiz to take the test.
9. Read every word of every question on the exam. Pay attention to details. They
provide clues and help prevent you from selecting the wrong answer choice.
10. Don’t spend too much time on any one question. You have up to six hours to
complete your exam—but you still can’t afford to spend too much time on any one
question. Try to maintain a steady pace. Due to the computer-adaptive nature of the
exam, it is more important to get the questions right so the exam is accurately
assessing your abilities.
Loading page 13...
GIVE US YOUR FEEDBACK
Peterson’s publishes a full line of books—test prep, education exploration, financial aid, and
career preparation. Peterson’s publications can be found at high school guidance offices, college
libraries and career centers, and your local bookstore and library. In addition, you can find
Peterson’s products online at www.petersons.com.
We welcome any comments or suggestions you may have about this publication. Please call
our customer service department at 800-338-3282 Ext. 54229 or send an email message to
custsvc@petersons.com. Your feedback will help us make educational dreams possible for you
—and others like you.
YOU’RE WELL ON YOUR WAY TO SUCCESS!
Remember that knowledge is power. Using Peterson’s Master the™ NCLEX-RN® will help you
become familiar with the kind of content that appears in the actual NCLEX-RN exam. We look
forward to helping you obtain your RN license. Good luck!
Peterson’s publishes a full line of books—test prep, education exploration, financial aid, and
career preparation. Peterson’s publications can be found at high school guidance offices, college
libraries and career centers, and your local bookstore and library. In addition, you can find
Peterson’s products online at www.petersons.com.
We welcome any comments or suggestions you may have about this publication. Please call
our customer service department at 800-338-3282 Ext. 54229 or send an email message to
custsvc@petersons.com. Your feedback will help us make educational dreams possible for you
—and others like you.
YOU’RE WELL ON YOUR WAY TO SUCCESS!
Remember that knowledge is power. Using Peterson’s Master the™ NCLEX-RN® will help you
become familiar with the kind of content that appears in the actual NCLEX-RN exam. We look
forward to helping you obtain your RN license. Good luck!
Loading page 14...
PART I
THE REGISTERED NURSING
PROFESSION AND THE NCLEX-RN®
CHAPTER 1 About the RN Profession and the NCLEX-RN®
THE REGISTERED NURSING
PROFESSION AND THE NCLEX-RN®
CHAPTER 1 About the RN Profession and the NCLEX-RN®
Loading page 15...
Chapter 1
About the RN Profession and the
NCLEX-RN®
OVERVIEW
• Registered Nurses and Their Career Outlook
• Nursing Education
• Licensure
• NCLEX-RN® Exam Basics
• Proven Test-Taking Strategies and Study Techniques
• NCLEX-RN® Test Plan
• Top 10 Strategies for Choosing the Correct Answer
• Summing It Up
Congratulations on your journey to becoming a registered nurse! By picking up this book, you’re
making a commitment to prep hard, pass your NCLEX-RN exam, and start along the path toward
the exciting, challenging, and vital career of nursing. This chapter will lay out the profession as
a whole and will explain all you need to know about the NCLEX-RN exam.
REGISTERED NURSES AND THEIR CAREER OUTLOOK
According to the National Council of State Boards of Nursing (NCSBN), there are currently more
than 4.8 million active registered nurses in the United States. Although the number of employed
registered nurses per population in each state varies widely, professional nurses are the largest
health care profession in the United States. According to the American Nurses Association
(ANA), there will be more registered nurse jobs available through 2022 than for any other
profession. The U.S. Bureau of Labor Statistics (2018) projects that 1.1 million new RNs will be
needed to avoid a further shortage. The projected need for additional nurses is due to the increased
emphasis on preventative care, increasing chronic conditions, and the overall demand for health
care services from the aging population that is living longer and engaging in more active lives.
According to the U.S. Bureau of Labor Statistics, between May 2016 and May 2017, the majority
of nurses earned an income ranging from $48,690 to $104,100 annually, with a median salary of
$70,000 per year. This figure represents a 3.7% increase compared to the previous year. Factors
that influence nursing salaries include specified areas of practice, employment environment,
length of practice, and educational level. Nursing salaries also vary from state to state.
About the RN Profession and the
NCLEX-RN®
OVERVIEW
• Registered Nurses and Their Career Outlook
• Nursing Education
• Licensure
• NCLEX-RN® Exam Basics
• Proven Test-Taking Strategies and Study Techniques
• NCLEX-RN® Test Plan
• Top 10 Strategies for Choosing the Correct Answer
• Summing It Up
Congratulations on your journey to becoming a registered nurse! By picking up this book, you’re
making a commitment to prep hard, pass your NCLEX-RN exam, and start along the path toward
the exciting, challenging, and vital career of nursing. This chapter will lay out the profession as
a whole and will explain all you need to know about the NCLEX-RN exam.
REGISTERED NURSES AND THEIR CAREER OUTLOOK
According to the National Council of State Boards of Nursing (NCSBN), there are currently more
than 4.8 million active registered nurses in the United States. Although the number of employed
registered nurses per population in each state varies widely, professional nurses are the largest
health care profession in the United States. According to the American Nurses Association
(ANA), there will be more registered nurse jobs available through 2022 than for any other
profession. The U.S. Bureau of Labor Statistics (2018) projects that 1.1 million new RNs will be
needed to avoid a further shortage. The projected need for additional nurses is due to the increased
emphasis on preventative care, increasing chronic conditions, and the overall demand for health
care services from the aging population that is living longer and engaging in more active lives.
According to the U.S. Bureau of Labor Statistics, between May 2016 and May 2017, the majority
of nurses earned an income ranging from $48,690 to $104,100 annually, with a median salary of
$70,000 per year. This figure represents a 3.7% increase compared to the previous year. Factors
that influence nursing salaries include specified areas of practice, employment environment,
length of practice, and educational level. Nursing salaries also vary from state to state.
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NURSING EDUCATION
Professional nursing education did not begin until 1860 in England, where nursing education was
founded on the principles established by Florence Nightingale. In 1873, the first school of nursing
established in the United States was based on those same principles. In the 1890s, nurses began
organizing significant professional associations, including the organizations now known as the
National League for Nursing and the American Nurses Association. During that period, state
nursing associations were beginning to form and were instrumental in establishing and passing
state registration acts. These acts intended to establish the legal title of the professional registered
nurse (RN) and to provide a licensing system for the practice of nursing. Currently, prelicensure
education includes accredited nursing programs that offer an associate degree, bachelor’s degree,
or master’s degree. Admission requirements to a nursing program vary based on the academic
institutional requirements.
LICENSURE
The requirements for eligibility to take the NCLEX-RN examination are determined by the state
board of nursing for the state in which the candidate intends to practice. The examination the
candidate will take to obtain licensure is developed by the NCSBN. The NCLEX-RN is a national
examination that does not contain state-specific information.
A licensed RN can only practice in the state for which licensure has been obtained. For an RN to
obtain licensure in another state, he or she must apply for endorsement by the desired state board
of nursing. It is not necessary to retake the NCLEX-RN examination; however, requirements
for licensure vary from state to state, so it is important to check with the specific state board of
nursing.
A compact license (or multistate license) is terminology that refers to the Nurse Licensure
Compact (NLC). The nurse included in an NLC has a primary license plus the ability to practice
in all NLC states. To be eligible for the NLC, the nurse must declare a compact state as his or her
legal residence. Nurses who reside in noncompact states may apply for licensure by endorsement,
which limits practice to a single-state license. There is no limit to how many single-state licenses
a nurse may hold.
An enhanced Nurse Licensure Compact (eNLC) was implemented on January 19, 2018, with
31 member states as of July 2019. The intent of the eNLC is to align licensing standards across
participating states, allowing nurses to have one multistate license with the ability to practice
in person or via telehealth in his or her home state as well as other eNLC states. See Appendix
A for contact information for the boards of nursing for each state belonging to the eNLC. It is
important to note that the board of nursing for each state has rules and regulations that define the
scope of practice within that state.
Professional nursing education did not begin until 1860 in England, where nursing education was
founded on the principles established by Florence Nightingale. In 1873, the first school of nursing
established in the United States was based on those same principles. In the 1890s, nurses began
organizing significant professional associations, including the organizations now known as the
National League for Nursing and the American Nurses Association. During that period, state
nursing associations were beginning to form and were instrumental in establishing and passing
state registration acts. These acts intended to establish the legal title of the professional registered
nurse (RN) and to provide a licensing system for the practice of nursing. Currently, prelicensure
education includes accredited nursing programs that offer an associate degree, bachelor’s degree,
or master’s degree. Admission requirements to a nursing program vary based on the academic
institutional requirements.
LICENSURE
The requirements for eligibility to take the NCLEX-RN examination are determined by the state
board of nursing for the state in which the candidate intends to practice. The examination the
candidate will take to obtain licensure is developed by the NCSBN. The NCLEX-RN is a national
examination that does not contain state-specific information.
A licensed RN can only practice in the state for which licensure has been obtained. For an RN to
obtain licensure in another state, he or she must apply for endorsement by the desired state board
of nursing. It is not necessary to retake the NCLEX-RN examination; however, requirements
for licensure vary from state to state, so it is important to check with the specific state board of
nursing.
A compact license (or multistate license) is terminology that refers to the Nurse Licensure
Compact (NLC). The nurse included in an NLC has a primary license plus the ability to practice
in all NLC states. To be eligible for the NLC, the nurse must declare a compact state as his or her
legal residence. Nurses who reside in noncompact states may apply for licensure by endorsement,
which limits practice to a single-state license. There is no limit to how many single-state licenses
a nurse may hold.
An enhanced Nurse Licensure Compact (eNLC) was implemented on January 19, 2018, with
31 member states as of July 2019. The intent of the eNLC is to align licensing standards across
participating states, allowing nurses to have one multistate license with the ability to practice
in person or via telehealth in his or her home state as well as other eNLC states. See Appendix
A for contact information for the boards of nursing for each state belonging to the eNLC. It is
important to note that the board of nursing for each state has rules and regulations that define the
scope of practice within that state.
Loading page 17...
NCLEX-RN® EXAM BASICS
The NCLEX-RN examination was developed to ensure the minimum knowledge, skills, and
abilities necessary to deliver safe, effective nursing care were present at an entry level. Entry
level is defined as six months or less of nursing experience. The examination is based on a test
plan that serves as a blueprint outlining the content on which the candidate will be tested. The
basic test plan for the NCLEX-RN is updated every three years to ensure the competencies that
are measured are current.
After reviewing the requirements and eligibility to take the NCLEX-RN examination as
determined by the board of nursing for the state in which the candidate intends to practice, all
candidates should access the NCSBN’s website (www.ncsbn.org) for the most up-to-date
information regarding the NCLEX-RN exam. The NCSBN website includes instructions for the
application and registration process, designated testing locations, and the current NCLEX-RN
Test Plan. The site will also tell you what to do to prepare before the exam, what to do the day
of the exam, and what occurs after the exam.
Computer Adaptive Testing
An interactive system called computer adaptive testing (CAT) is used to administer the
NCLEX-RN examination. CAT uses computer technology and measurement theory to provide a
valid and reliable measurement of nursing competence. Each NCLEX-RN examination is unique
because the technology can interactively select questions that match the candidate’s ability based
on the previous questions that have been answered. The chosen questions are classified by test
plan category and level of difficulty. This testing process continues until the candidate’s
knowledge and skills meet the NCLEX-RN test plan requirements and until a pass or fail decision
is made.
The NCLEX-RN test questions can range from 75 to 265 items. This number includes 15 items
classified as pretest items, which are not scored. There is a maximum time limit of 6 hours for the
examination; there is no minimum time limit. The allotted maximum time includes time allocated
for the tutorial and sample items, as well as all optional breaks during the exam.
Test questions are presented one at a time on the computer screen. The item shown must be
answered in order to proceed to the next. Once an answer is submitted, you will no longer have
the ability to return to the previous item.
The overall duration for the NCLEX-RN examination is determined by the amount of correct
and incorrect responses to the items. The computer-adaptive nature of the examination selects
items based on your responses. Each item requires a varied amount of time to complete. A good
rule of thumb is to spend 1–2 minutes on each test item to maintain an adequate pace throughout
the exam.
The length of your examination is not an indication of a pass or fail result, as it is possible to fail
regardless of the length of the examination. The decision for passing or failing the NCLEX-RN
examination is governed in the following three ways:
1. The examination ends when it can be determined with 95% confidence that your
performance is either above or below the passing standard, regardless of the number of
items answered or the amount of testing time that has elapsed.
2. If your ability levels are very close to the passing standard, the computer will continue
to administer items until the maximum number is reached. At this point, the 95%
confidence rule is disregarded, and the final ability is estimated. If the final ability is
above the passing standard, then you will pass, and if it is below, you will fail the exam.
3. If you run out of time and the computer has not determined with 95% certainty whether
you have passed or failed, alternative criteria are used. If at least the minimum number
of required items were answered, the computer looks at the last 60 ability estimates. This
does not mean that you had to answer the last 60 questions correctly. Each ability
estimate is based on all previous answers. If the last 60 ability estimates were
consistently above the passing standard, you would pass. If your ability estimate drops
below the passing standard even once in the previous 60 items, you will fail the exam.
The NCLEX-RN examination was developed to ensure the minimum knowledge, skills, and
abilities necessary to deliver safe, effective nursing care were present at an entry level. Entry
level is defined as six months or less of nursing experience. The examination is based on a test
plan that serves as a blueprint outlining the content on which the candidate will be tested. The
basic test plan for the NCLEX-RN is updated every three years to ensure the competencies that
are measured are current.
After reviewing the requirements and eligibility to take the NCLEX-RN examination as
determined by the board of nursing for the state in which the candidate intends to practice, all
candidates should access the NCSBN’s website (www.ncsbn.org) for the most up-to-date
information regarding the NCLEX-RN exam. The NCSBN website includes instructions for the
application and registration process, designated testing locations, and the current NCLEX-RN
Test Plan. The site will also tell you what to do to prepare before the exam, what to do the day
of the exam, and what occurs after the exam.
Computer Adaptive Testing
An interactive system called computer adaptive testing (CAT) is used to administer the
NCLEX-RN examination. CAT uses computer technology and measurement theory to provide a
valid and reliable measurement of nursing competence. Each NCLEX-RN examination is unique
because the technology can interactively select questions that match the candidate’s ability based
on the previous questions that have been answered. The chosen questions are classified by test
plan category and level of difficulty. This testing process continues until the candidate’s
knowledge and skills meet the NCLEX-RN test plan requirements and until a pass or fail decision
is made.
The NCLEX-RN test questions can range from 75 to 265 items. This number includes 15 items
classified as pretest items, which are not scored. There is a maximum time limit of 6 hours for the
examination; there is no minimum time limit. The allotted maximum time includes time allocated
for the tutorial and sample items, as well as all optional breaks during the exam.
Test questions are presented one at a time on the computer screen. The item shown must be
answered in order to proceed to the next. Once an answer is submitted, you will no longer have
the ability to return to the previous item.
The overall duration for the NCLEX-RN examination is determined by the amount of correct
and incorrect responses to the items. The computer-adaptive nature of the examination selects
items based on your responses. Each item requires a varied amount of time to complete. A good
rule of thumb is to spend 1–2 minutes on each test item to maintain an adequate pace throughout
the exam.
The length of your examination is not an indication of a pass or fail result, as it is possible to fail
regardless of the length of the examination. The decision for passing or failing the NCLEX-RN
examination is governed in the following three ways:
1. The examination ends when it can be determined with 95% confidence that your
performance is either above or below the passing standard, regardless of the number of
items answered or the amount of testing time that has elapsed.
2. If your ability levels are very close to the passing standard, the computer will continue
to administer items until the maximum number is reached. At this point, the 95%
confidence rule is disregarded, and the final ability is estimated. If the final ability is
above the passing standard, then you will pass, and if it is below, you will fail the exam.
3. If you run out of time and the computer has not determined with 95% certainty whether
you have passed or failed, alternative criteria are used. If at least the minimum number
of required items were answered, the computer looks at the last 60 ability estimates. This
does not mean that you had to answer the last 60 questions correctly. Each ability
estimate is based on all previous answers. If the last 60 ability estimates were
consistently above the passing standard, you would pass. If your ability estimate drops
below the passing standard even once in the previous 60 items, you will fail the exam.
Loading page 18...
PROVEN TEST-TAKING STRATEGIES AND STUDY
TECHNIQUES
As mentioned previously, it is important to familiarize yourself with the information on the
NCSBN’s website (www.ncsbn.org). Remember when you demanded a study guide in nursing
school before an exam? Similarly, the NCSBN has provided you with a detailed test plan. The
test plan is there to help guide you into the role of a safe, competent nurse.
NOTE
Remember that the practice tests found in this book are also available online at
www.petersons.com/testprep/nclex. Since the NCLEX-RN examination is administered on
a computer, it’s helpful to practice as much as possible on a computer.
Your key to NCLEX-RN success lies in the effort that you put into your NCLEX-RN preparation.
Devise a study plan, stay organized, study consistently, and begin reviewing for the NCLEX-RN
early. It is essential that you make time daily to prepare for the examination in an environment
that is conducive to test taking. Make sure your study environment is quiet. Before every study
session you should be rested, well nourished, and comfortable. If possible, get into the habit of
reviewing practice questions on the computer. Sticking to a structured study plan will make your
test preparation effective and keep you focused on reaching your goal: passing the NCLEX-RN.
To begin your NCLEX-RN test preparation, take the Diagnostic Test (Chapter 2), which is
designed to assess your knowledge strengths and weaknesses. After scoring your test and reading
the answer explanations, use the Diagnostic Test Assessment Grid (page 57) to help you pinpoint
your trouble areas. If your test score indicates a need to focus on a specific subject area, your
next step is to review that subject matter first.
After you have thoroughly reviewed the material, be sure to reinforce your understanding of the
concepts presented in the chapters by answering the practice question sets. How well you do on
the practice questions will help you gauge how effectively you are studying and retaining the
information presented. Once you are feeling confident about the material you have reviewed,
retest your knowledge using Practice Test 2, review the material again where needed, and follow
the same process with Practice Test 3. Remember, these tests are accessible online, so not only
can you practice with test-like questions, but you can also get comfortable taking a test on the
computer.
When you review NCLEX-RN test questions, read every explanation to every answer, even if
you selected the correct response. Doing so is a great way to reinforce what you know, identify
remaining trouble areas, and clarify concepts that might still be a bit unclear. Take the time to jot
down what you need to review, and then spend time doing so. Then, when you have completed
your review of the material, answer more practice test questions to re-evaluate your knowledge.
This drill-and-review approach will help you to sound the concepts deep into your memory; once
you have the concepts well in mind, their application on the NCLEX-RN should come easily.
TIP
The NCLEX-RN examination is not designed to assess your ability to memorize, but to
determine your knowledge of the subjects and content areas. Take the time to review the
content, test your abilities, identify what you need to review, and then review to reinforce what
you already know.
As stated earlier in the discussion about CAT testing, each item must be answered, or you will not
be able to proceed to the next question. If you are unsure of the correct answer, DO NOT guess.
Every time you answer an item, the computer re-estimates your ability. If you are unsure, reread
the scenario to evaluate precisely what the question is asking of you and then begin eliminating
wrong answers.
After you review the scenario, ask yourself the following questions:
TECHNIQUES
As mentioned previously, it is important to familiarize yourself with the information on the
NCSBN’s website (www.ncsbn.org). Remember when you demanded a study guide in nursing
school before an exam? Similarly, the NCSBN has provided you with a detailed test plan. The
test plan is there to help guide you into the role of a safe, competent nurse.
NOTE
Remember that the practice tests found in this book are also available online at
www.petersons.com/testprep/nclex. Since the NCLEX-RN examination is administered on
a computer, it’s helpful to practice as much as possible on a computer.
Your key to NCLEX-RN success lies in the effort that you put into your NCLEX-RN preparation.
Devise a study plan, stay organized, study consistently, and begin reviewing for the NCLEX-RN
early. It is essential that you make time daily to prepare for the examination in an environment
that is conducive to test taking. Make sure your study environment is quiet. Before every study
session you should be rested, well nourished, and comfortable. If possible, get into the habit of
reviewing practice questions on the computer. Sticking to a structured study plan will make your
test preparation effective and keep you focused on reaching your goal: passing the NCLEX-RN.
To begin your NCLEX-RN test preparation, take the Diagnostic Test (Chapter 2), which is
designed to assess your knowledge strengths and weaknesses. After scoring your test and reading
the answer explanations, use the Diagnostic Test Assessment Grid (page 57) to help you pinpoint
your trouble areas. If your test score indicates a need to focus on a specific subject area, your
next step is to review that subject matter first.
After you have thoroughly reviewed the material, be sure to reinforce your understanding of the
concepts presented in the chapters by answering the practice question sets. How well you do on
the practice questions will help you gauge how effectively you are studying and retaining the
information presented. Once you are feeling confident about the material you have reviewed,
retest your knowledge using Practice Test 2, review the material again where needed, and follow
the same process with Practice Test 3. Remember, these tests are accessible online, so not only
can you practice with test-like questions, but you can also get comfortable taking a test on the
computer.
When you review NCLEX-RN test questions, read every explanation to every answer, even if
you selected the correct response. Doing so is a great way to reinforce what you know, identify
remaining trouble areas, and clarify concepts that might still be a bit unclear. Take the time to jot
down what you need to review, and then spend time doing so. Then, when you have completed
your review of the material, answer more practice test questions to re-evaluate your knowledge.
This drill-and-review approach will help you to sound the concepts deep into your memory; once
you have the concepts well in mind, their application on the NCLEX-RN should come easily.
TIP
The NCLEX-RN examination is not designed to assess your ability to memorize, but to
determine your knowledge of the subjects and content areas. Take the time to review the
content, test your abilities, identify what you need to review, and then review to reinforce what
you already know.
As stated earlier in the discussion about CAT testing, each item must be answered, or you will not
be able to proceed to the next question. If you are unsure of the correct answer, DO NOT guess.
Every time you answer an item, the computer re-estimates your ability. If you are unsure, reread
the scenario to evaluate precisely what the question is asking of you and then begin eliminating
wrong answers.
After you review the scenario, ask yourself the following questions:
Loading page 19...
• What exactly am I being asked to do?
• Where am I in the nursing process?
• At what level of Maslow’s hierarchy of needs is the client?
• What is developmentally appropriate for the client?
• Is there a safety component?
Before eliminating answers, ask yourself the following questions:
• Is this reasonable and appropriate for the situation?
• Is this the safest choice for the client?
• Is this the most important thing that I can do for the client at this time?
If you are answering a multiple-choice question, choose the most comprehensive answer that
encompasses all of the other choices that apply to the situation. If you are answering a multiple-
response question, the answers are either true or false in relation to the scenario.
TIP
Do NOT guess if you are unsure of the answer to a question. Evaluate what the question is
asking of you, and then eliminate wrong answers. This approach will result in a more accurate
CAT assessment of your abilities on the actual NCLEX-RN examination.
Your responses should put the client first rather than items such as tasks, paperwork, charting, or
other members of the health care team. It is important to remember that the nursing profession
is about the client. There is nothing else you should be doing other than taking care of the client
to whom you are assigned.
In addition, your answers should be based only on the question as provided to you; make sure
you are not reading anything into the given situation or scenario. The NCLEX-RN scenario has
provided you with exactly the information that you need to respond appropriately.
NCLEX-RN® TEST PLAN
All task statements in the 2019 NCLEX-RN Test Plan require that you apply the fundamental
principles of clinical decision making and critical thinking to nursing practice. You will integrate
concepts from the social sciences (psychology and sociology), biological sciences (anatomy,
physiology, biology, and microbiology), and physical sciences (chemistry and physics).
Integrated Nursing Processes
Processes that are fundamental to the practice of nursing have been identified by the NCSBN and
are integrated throughout the Client Needs categories and subcategories. The processes identified
and defined by the NCSBN include those listed below.
• Nursing Process is a scientific, clinical reasoning approach to client care that includes
assessment, analysis, planning, implementation, and evaluation.
• Caring involves the interaction of the nurse and client in an atmosphere of mutual respect
and trust. In this collaborative environment, the nurse provides encouragement, hope,
support, and compassion to help achieve desired outcomes.
• Communication and Documentation includes the verbal and nonverbal interactions
between the nurse and the client, the client’s family, and the other members of the health
care team. Events and activities associated with client care are recorded in written and/or
electronic records that demonstrate adherence to the standards of practice and
accountability in the provision of care.
• Teaching/Learning refers to facilitating the acquisition of knowledge, skills, and abilities
to promote a change in behavior.
• Culture and Spirituality involves the interaction of the nurse and the client (individual,
family, or group, including significant others and populations), which recognizes and
considers the client-reported, self-identified, unique, and individual preferences to client
• Where am I in the nursing process?
• At what level of Maslow’s hierarchy of needs is the client?
• What is developmentally appropriate for the client?
• Is there a safety component?
Before eliminating answers, ask yourself the following questions:
• Is this reasonable and appropriate for the situation?
• Is this the safest choice for the client?
• Is this the most important thing that I can do for the client at this time?
If you are answering a multiple-choice question, choose the most comprehensive answer that
encompasses all of the other choices that apply to the situation. If you are answering a multiple-
response question, the answers are either true or false in relation to the scenario.
TIP
Do NOT guess if you are unsure of the answer to a question. Evaluate what the question is
asking of you, and then eliminate wrong answers. This approach will result in a more accurate
CAT assessment of your abilities on the actual NCLEX-RN examination.
Your responses should put the client first rather than items such as tasks, paperwork, charting, or
other members of the health care team. It is important to remember that the nursing profession
is about the client. There is nothing else you should be doing other than taking care of the client
to whom you are assigned.
In addition, your answers should be based only on the question as provided to you; make sure
you are not reading anything into the given situation or scenario. The NCLEX-RN scenario has
provided you with exactly the information that you need to respond appropriately.
NCLEX-RN® TEST PLAN
All task statements in the 2019 NCLEX-RN Test Plan require that you apply the fundamental
principles of clinical decision making and critical thinking to nursing practice. You will integrate
concepts from the social sciences (psychology and sociology), biological sciences (anatomy,
physiology, biology, and microbiology), and physical sciences (chemistry and physics).
Integrated Nursing Processes
Processes that are fundamental to the practice of nursing have been identified by the NCSBN and
are integrated throughout the Client Needs categories and subcategories. The processes identified
and defined by the NCSBN include those listed below.
• Nursing Process is a scientific, clinical reasoning approach to client care that includes
assessment, analysis, planning, implementation, and evaluation.
• Caring involves the interaction of the nurse and client in an atmosphere of mutual respect
and trust. In this collaborative environment, the nurse provides encouragement, hope,
support, and compassion to help achieve desired outcomes.
• Communication and Documentation includes the verbal and nonverbal interactions
between the nurse and the client, the client’s family, and the other members of the health
care team. Events and activities associated with client care are recorded in written and/or
electronic records that demonstrate adherence to the standards of practice and
accountability in the provision of care.
• Teaching/Learning refers to facilitating the acquisition of knowledge, skills, and abilities
to promote a change in behavior.
• Culture and Spirituality involves the interaction of the nurse and the client (individual,
family, or group, including significant others and populations), which recognizes and
considers the client-reported, self-identified, unique, and individual preferences to client
Loading page 20...
care, the applicable standard of care, and legal considerations.
In addition to using the nursing process, you will be expected to apply concepts such as caring,
communication, documentation, teaching and learning, and culture and spirituality throughout
the four major categories of the test plan.
The content of the NCLEX-RN Test Plan is organized into four major client needs categories.
Two of the four categories are divided into subcategories, as shown in the following list.
Client Needs Categories and Subcategories
1. Safe and Effective Care Environment
Management of Care
Safety and Infection Control
2. Health Promotion and Maintenance
3. Psychosocial Integrity
4. Physiological Integrity
Basic Care and Comfort
Pharmacological and Parenteral Therapies
Reduction of Risk Potential
Physiological Adaptation
Safe and Effective Care Environment
This first major Client Needs category consists of two subcategories, each of which assesses
your ability to promote favorable client outcomes by providing and directing nursing care that
enhances the care delivery setting in order to protect clients and health care personnel.
Management of Care
This subcategory is designed to assess your ability to provide and direct nursing care that enhances
the care delivery setting to protect the client and health care personnel.
MANAGEMENT OF CARE
Related Activity Statements from the 2017 RN Practice Analysis: Linking the NCLEX-RN
Examination to Practice
• Integrate advanced directives into the client plan of care.
• Assign and supervise care of the client provided by others (e.g., LPN/VN, assistive
personnel, other RNs).
• Organize your workload to manage time effectively.
• Practice and advocate for cost-effective care.
• Initiate, evaluate, and update the client plan of care.
• Provide education to clients and staff about client rights and responsibilities.
• Advocate for client rights and needs.
• Collaborate with interprofessional team members when providing client care.
• Manage conflict among clients and health care staff.
• Maintain client confidentiality and privacy.
• Provide and receive handoff of care reports on assigned clients.
• Use approved abbreviations and standard terminology when documenting care.
• Perform procedures necessary to safely admit, transfer, and/or discharge a client.
• Prioritize the delivery of client care.
• Recognize ethical dilemmas and take appropriate action.
• Practice in a manner consistent with a code of ethics for nurses.
In addition to using the nursing process, you will be expected to apply concepts such as caring,
communication, documentation, teaching and learning, and culture and spirituality throughout
the four major categories of the test plan.
The content of the NCLEX-RN Test Plan is organized into four major client needs categories.
Two of the four categories are divided into subcategories, as shown in the following list.
Client Needs Categories and Subcategories
1. Safe and Effective Care Environment
Management of Care
Safety and Infection Control
2. Health Promotion and Maintenance
3. Psychosocial Integrity
4. Physiological Integrity
Basic Care and Comfort
Pharmacological and Parenteral Therapies
Reduction of Risk Potential
Physiological Adaptation
Safe and Effective Care Environment
This first major Client Needs category consists of two subcategories, each of which assesses
your ability to promote favorable client outcomes by providing and directing nursing care that
enhances the care delivery setting in order to protect clients and health care personnel.
Management of Care
This subcategory is designed to assess your ability to provide and direct nursing care that enhances
the care delivery setting to protect the client and health care personnel.
MANAGEMENT OF CARE
Related Activity Statements from the 2017 RN Practice Analysis: Linking the NCLEX-RN
Examination to Practice
• Integrate advanced directives into the client plan of care.
• Assign and supervise care of the client provided by others (e.g., LPN/VN, assistive
personnel, other RNs).
• Organize your workload to manage time effectively.
• Practice and advocate for cost-effective care.
• Initiate, evaluate, and update the client plan of care.
• Provide education to clients and staff about client rights and responsibilities.
• Advocate for client rights and needs.
• Collaborate with interprofessional team members when providing client care.
• Manage conflict among clients and health care staff.
• Maintain client confidentiality and privacy.
• Provide and receive handoff of care reports on assigned clients.
• Use approved abbreviations and standard terminology when documenting care.
• Perform procedures necessary to safely admit, transfer, and/or discharge a client.
• Prioritize the delivery of client care.
• Recognize ethical dilemmas and take appropriate action.
• Practice in a manner consistent with a code of ethics for nurses.
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• Verify the client receives appropriate education and consents for care and procedures.
• Receive and transcribe health care provider orders.
• Utilize resources to enhance client care (e.g., evidenced-based research, information
technology, policies and procedures).
• Recognize limitations of yourself and others and utilize resources.
• Report client conditions as required by law (e.g., abuse/neglect, communicable disease).
• Provide care within the legal scope of practice.
• Participate in performance improvement projects and quality improvement processes.
• Assess the need for referrals and obtain necessary orders.
Related content includes, but is not limited to, the following:
• Advance directives/self-determination/life planning
• Advocacy
• Assignment, delegation, and supervision
• Case management
• Client rights
• Collaboration with interdisciplinary team
• Concepts of management
• Confidentiality/information security
• Continuity of care
• Establishing priorities
• Ethical practice
• Informed consent
• Information technology
• Legal rights and responsibilities
• Performance improvement (quality improvement)
• Referrals
Safety and Infection Control
This Safe and Effective Care Environment subcategory assesses your ability to protect clients
and health care personnel from health and environmental hazards.
SAFETY AND INFECTION CONTROL
Related Activity Statements from the 2017 RN Practice Analysis: Linking the NCLEX-RN
Examination to Practice
• Receive and transcribe health care provider orders.
• Utilize resources to enhance client care (e.g., evidenced-based research, information
technology, policies and procedures).
• Recognize limitations of yourself and others and utilize resources.
• Report client conditions as required by law (e.g., abuse/neglect, communicable disease).
• Provide care within the legal scope of practice.
• Participate in performance improvement projects and quality improvement processes.
• Assess the need for referrals and obtain necessary orders.
Related content includes, but is not limited to, the following:
• Advance directives/self-determination/life planning
• Advocacy
• Assignment, delegation, and supervision
• Case management
• Client rights
• Collaboration with interdisciplinary team
• Concepts of management
• Confidentiality/information security
• Continuity of care
• Establishing priorities
• Ethical practice
• Informed consent
• Information technology
• Legal rights and responsibilities
• Performance improvement (quality improvement)
• Referrals
Safety and Infection Control
This Safe and Effective Care Environment subcategory assesses your ability to protect clients
and health care personnel from health and environmental hazards.
SAFETY AND INFECTION CONTROL
Related Activity Statements from the 2017 RN Practice Analysis: Linking the NCLEX-RN
Examination to Practice
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• Assess the client for allergies and intervene as needed (e.g., food, latex, environmental
allergies).
• Protect the client from injury (e.g., falls, electrical hazards).
• Ensure proper identification of the client when providing care.
• Verify the appropriateness and accuracy of a treatment order.
• Participate in emergency response plans (e.g., internal/external disaster, bomb threat,
community planning).
• Use ergonomic principles when providing care (e.g., safe client handling, proper lifting).
• Follow procedures for handling biohazardous and hazardous materials.
• Educate the client on safety issues.
• Acknowledge and document practice errors and near misses (e.g., incident report for
medication error).
• Report any unsafe practice of health care personnel and intervene as appropriate (e.g.,
substance abuse, improper care, staffing practices).
• Facilitate the appropriate and safe use of equipment.
• Follow the security plan procedures (e.g., newborn nursery security, violence, controlled
access).
• Apply principles of infection control (e.g., hand hygiene, aseptic technique, isolation,
sterile technique, universal/standard precautions).
• Educate the client and staff regarding infection control measures.
• Follow requirements for the use of restraints.
Related content includes, but is not limited to, the following:
• Accident/error/injury prevention
• Emergency response plan
• Ergonomic principles
• Handling hazardous and infectious materials
• Home safety
• Reporting of incident/event/irregular occurrence/variance
• Safe use of equipment
• Security plan
• Standard precautions/transmission-based precautions/surgical asepsis
• Use of restraints/safety devices
Health Promotion and Maintenance
This second major Client Needs category assesses your ability to provide and direct the nursing
care of the client that incorporates knowledge of expected growth and development, prevention
and early detection of health problems, and strategies to achieve optimal health.
HEALTH PROMOTION AND MAINTENANCE
Related Activity Statements from the 2017 RN Practice Analysis: Linking the NCLEX-RN
Examination to Practice
allergies).
• Protect the client from injury (e.g., falls, electrical hazards).
• Ensure proper identification of the client when providing care.
• Verify the appropriateness and accuracy of a treatment order.
• Participate in emergency response plans (e.g., internal/external disaster, bomb threat,
community planning).
• Use ergonomic principles when providing care (e.g., safe client handling, proper lifting).
• Follow procedures for handling biohazardous and hazardous materials.
• Educate the client on safety issues.
• Acknowledge and document practice errors and near misses (e.g., incident report for
medication error).
• Report any unsafe practice of health care personnel and intervene as appropriate (e.g.,
substance abuse, improper care, staffing practices).
• Facilitate the appropriate and safe use of equipment.
• Follow the security plan procedures (e.g., newborn nursery security, violence, controlled
access).
• Apply principles of infection control (e.g., hand hygiene, aseptic technique, isolation,
sterile technique, universal/standard precautions).
• Educate the client and staff regarding infection control measures.
• Follow requirements for the use of restraints.
Related content includes, but is not limited to, the following:
• Accident/error/injury prevention
• Emergency response plan
• Ergonomic principles
• Handling hazardous and infectious materials
• Home safety
• Reporting of incident/event/irregular occurrence/variance
• Safe use of equipment
• Security plan
• Standard precautions/transmission-based precautions/surgical asepsis
• Use of restraints/safety devices
Health Promotion and Maintenance
This second major Client Needs category assesses your ability to provide and direct the nursing
care of the client that incorporates knowledge of expected growth and development, prevention
and early detection of health problems, and strategies to achieve optimal health.
HEALTH PROMOTION AND MAINTENANCE
Related Activity Statements from the 2017 RN Practice Analysis: Linking the NCLEX-RN
Examination to Practice
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• Provide care and education for the newborn, infant, and toddler client from birth through
2 years old.
• Provide care and education for the preschool, school age, and adolescent client ages 3
through 17 years.
• Provide care and education for the adult client ages 18 through 64 years.
• Provide care and education for the adult client ages 65 years and over.
• Provide prenatal care and education.
• Provide care and education to an antepartum client or a client in labor.
• Provide postpartum care and education.
• Assess and educate clients about health risks based on family, population, and
community characteristics.
• Assess the client’s readiness to learn, learning preferences, and barriers to learning.
• Plan and/or participate in community health education.
• Educate the client about health promotion and maintenance recommendations (e.g.,
physician visits, immunizations).
• Perform targeted screening assessments (e.g., vision, nutrition).
• Educate the client about prevention and treatment of high-risk health behaviors (e.g.,
smoking cessation, safe sexual practices, needle exchange).
• Assess the client’s ability to manage care in the home environment and plan care
accordingly.
• Perform comprehensive health assessments.
Related content includes, but is not limited to, the following:
• The aging process
• Ante/intra/postpartum and newborn care
• Developmental stages and transitions
• Health promotion/disease prevention
• Health screening
• High-risk behaviors
• Lifestyle choices
• Self-care
• Techniques of physical assessment
Psychosocial Integrity
The third major Client Needs category assesses your ability to provide and direct nursing care
that promotes and supports the emotional, mental, and social well-being of the client who is
experiencing stressful events, as well as clients with acute or chronic mental illness.
PSYCHOSOCIAL INTEGRITY
Related Activity Statements from the 2017 RN Practice Analysis: Linking the NCLEX-RN
Examination to Practice
2 years old.
• Provide care and education for the preschool, school age, and adolescent client ages 3
through 17 years.
• Provide care and education for the adult client ages 18 through 64 years.
• Provide care and education for the adult client ages 65 years and over.
• Provide prenatal care and education.
• Provide care and education to an antepartum client or a client in labor.
• Provide postpartum care and education.
• Assess and educate clients about health risks based on family, population, and
community characteristics.
• Assess the client’s readiness to learn, learning preferences, and barriers to learning.
• Plan and/or participate in community health education.
• Educate the client about health promotion and maintenance recommendations (e.g.,
physician visits, immunizations).
• Perform targeted screening assessments (e.g., vision, nutrition).
• Educate the client about prevention and treatment of high-risk health behaviors (e.g.,
smoking cessation, safe sexual practices, needle exchange).
• Assess the client’s ability to manage care in the home environment and plan care
accordingly.
• Perform comprehensive health assessments.
Related content includes, but is not limited to, the following:
• The aging process
• Ante/intra/postpartum and newborn care
• Developmental stages and transitions
• Health promotion/disease prevention
• Health screening
• High-risk behaviors
• Lifestyle choices
• Self-care
• Techniques of physical assessment
Psychosocial Integrity
The third major Client Needs category assesses your ability to provide and direct nursing care
that promotes and supports the emotional, mental, and social well-being of the client who is
experiencing stressful events, as well as clients with acute or chronic mental illness.
PSYCHOSOCIAL INTEGRITY
Related Activity Statements from the 2017 RN Practice Analysis: Linking the NCLEX-RN
Examination to Practice
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• Assess the client for abuse or neglect and intervene as appropriate.
• Incorporate behavioral management techniques when caring for a client.
• Assess the client’s ability to cope with life changes and provide support.
• Assess the potential for violence and use safety precautions.
• Incorporate client cultural practices and beliefs when planning and providing care.
• Provide end-of-life care and education to clients.
• Assess family dynamics to determine a plan of care.
• Provide care for a client who is experiencing grief or loss.
• Provide care and education for acute and chronic psychosocial health issues (e.g.,
addictions/dependencies, depression, dementia, eating disorders).
• Assess psychosocial, spiritual, and/or occupational factors affecting care and plan
interventions.
• Provide care for a client experiencing visual, auditory, and/or cognitive distortions.
• Recognize nonverbal cues to physical and/or psychological stressors.
• Assess the client for substance abuse, dependency, withdrawal, or toxicities and
intervene as appropriate.
• Use therapeutic communication techniques.
• Promote a therapeutic environment.
Related content includes, but is not limited to, the following:
• Abuse/neglect
• Behavioral interventions
• Coping mechanisms
• Crisis intervention
• Cultural awareness/cultural influences on health
• End-of-life care
• Family dynamics
• Grief and loss
• Mental health concepts
• Religious and spiritual influences on health
• Sensory/perceptual alterations
• Stress management
• Substance use and other disorders and dependencies
• Support systems
• Therapeutic communication
• Therapeutic environment
Physiological Integrity
The fourth major Client Needs category consists of four subcategories that assess your ability
to promote physical health and wellness by providing care and comfort, reducing client risk
potential, and managing health alterations.
Basic Care and Comfort
This subcategory is intended to assess your ability to provide comfort and assistance in the
performance of activities of daily living.
• Incorporate behavioral management techniques when caring for a client.
• Assess the client’s ability to cope with life changes and provide support.
• Assess the potential for violence and use safety precautions.
• Incorporate client cultural practices and beliefs when planning and providing care.
• Provide end-of-life care and education to clients.
• Assess family dynamics to determine a plan of care.
• Provide care for a client who is experiencing grief or loss.
• Provide care and education for acute and chronic psychosocial health issues (e.g.,
addictions/dependencies, depression, dementia, eating disorders).
• Assess psychosocial, spiritual, and/or occupational factors affecting care and plan
interventions.
• Provide care for a client experiencing visual, auditory, and/or cognitive distortions.
• Recognize nonverbal cues to physical and/or psychological stressors.
• Assess the client for substance abuse, dependency, withdrawal, or toxicities and
intervene as appropriate.
• Use therapeutic communication techniques.
• Promote a therapeutic environment.
Related content includes, but is not limited to, the following:
• Abuse/neglect
• Behavioral interventions
• Coping mechanisms
• Crisis intervention
• Cultural awareness/cultural influences on health
• End-of-life care
• Family dynamics
• Grief and loss
• Mental health concepts
• Religious and spiritual influences on health
• Sensory/perceptual alterations
• Stress management
• Substance use and other disorders and dependencies
• Support systems
• Therapeutic communication
• Therapeutic environment
Physiological Integrity
The fourth major Client Needs category consists of four subcategories that assess your ability
to promote physical health and wellness by providing care and comfort, reducing client risk
potential, and managing health alterations.
Basic Care and Comfort
This subcategory is intended to assess your ability to provide comfort and assistance in the
performance of activities of daily living.
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BASIC CARE AND COMFORT
Related Activity Statements from the 2017 RN Practice Analysis: Linking the NCLEX-RN
Examination to Practice
• Assist the client to compensate for a physical or sensory impairment (e.g., assistive
devices, positioning, compensatory techniques).
• Assess and manage clients with an alteration in elimination.
• Perform irrigations (e.g., of bladder, ear, eye).
• Perform skin assessment and/or implement measures to maintain skin integrity and
prevent skin breakdown.
• Apply, maintain, or remove orthopedic devices.
• Implement measures to promote circulation (e.g., active or passive range of motion,
positioning, and mobilization).
• Assess the client for pain and intervene as appropriate.
• Recognize complementary therapies and identify potential contraindications (e.g.,
aromatherapy, acupressure, supplements).
• Provide nonpharmacological comfort measures.
• Monitor the client’s nutritional status.
• Provide nutrition to the client through tube feedings.
• Evaluate client intake and output, and intervene as needed.
• Assess and/or intervene in the client’s performance of activities of daily living.
• Perform postmortem care.
• Assess the client’s sleep/rest pattern and intervene as needed.
Related content includes, but is not limited to, the following:
• Assistive devices
• Elimination
• Mobility/immobility
• Nonpharmacological comfort interventions
• Nutrition and oral hydration
• Personal hygiene
• Rest and sleep
Pharmacological and Parenteral Therapies
This subcategory assesses your ability to provide care related to the administration of medications
and parenteral therapies.
PHARMACOLOGICAL AND PARENTERAL THERAPIES
Related Activity Statements from the 2017 RN Practice Analysis: Linking the NCLEX-RN®
Examination to Practice
Related Activity Statements from the 2017 RN Practice Analysis: Linking the NCLEX-RN
Examination to Practice
• Assist the client to compensate for a physical or sensory impairment (e.g., assistive
devices, positioning, compensatory techniques).
• Assess and manage clients with an alteration in elimination.
• Perform irrigations (e.g., of bladder, ear, eye).
• Perform skin assessment and/or implement measures to maintain skin integrity and
prevent skin breakdown.
• Apply, maintain, or remove orthopedic devices.
• Implement measures to promote circulation (e.g., active or passive range of motion,
positioning, and mobilization).
• Assess the client for pain and intervene as appropriate.
• Recognize complementary therapies and identify potential contraindications (e.g.,
aromatherapy, acupressure, supplements).
• Provide nonpharmacological comfort measures.
• Monitor the client’s nutritional status.
• Provide nutrition to the client through tube feedings.
• Evaluate client intake and output, and intervene as needed.
• Assess and/or intervene in the client’s performance of activities of daily living.
• Perform postmortem care.
• Assess the client’s sleep/rest pattern and intervene as needed.
Related content includes, but is not limited to, the following:
• Assistive devices
• Elimination
• Mobility/immobility
• Nonpharmacological comfort interventions
• Nutrition and oral hydration
• Personal hygiene
• Rest and sleep
Pharmacological and Parenteral Therapies
This subcategory assesses your ability to provide care related to the administration of medications
and parenteral therapies.
PHARMACOLOGICAL AND PARENTERAL THERAPIES
Related Activity Statements from the 2017 RN Practice Analysis: Linking the NCLEX-RN®
Examination to Practice
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• Administer blood products and evaluate client response.
• Assess central venous access devices.
• Perform calculations needed for medication administration.
• Evaluate client response to medication.
• Educate the client about medications.
• Prepare and administer medications using the rights of medication administration.
• Review pertinent data prior to medication administration (e.g., contraindications, lab
results, allergies, potential interactions).
• Participate in the medication reconciliation process.
• Titrate the dosage of medication based on assessment and ordered parameters.
• Handle and maintain medication in a safe and controlled environment.
• Evaluate the appropriateness and accuracy of the medication order for the client.
• Handle and/or administer high-risk medications.
• Monitor intravenous infusions and maintain the site.
• Administer medications for pain management.
• Handle and/or administer controlled substances within regulatory guidelines.
• Administer parenteral nutrition and evaluate the client’s response.
Related content includes, but is not limited to, the following:
• Adverse effects/contraindications/side effects/interactions
• Blood and blood products
• Central venous access devices
• Dosage calculation
• Expected actions/outcomes
• Medication administration
• Parenteral/intravenous therapies
• Pharmacological pain management
• Total parenteral nutrition (TPN)
Reduction of Risk Potential
This subcategory assesses your ability to reduce the likelihood that clients will develop
complications or health problems related to existing conditions, treatments, or procedures.
REDUCTION OF RISK POTENTIAL
Related Activity Statements from the 2017 RN Practice Analysis: Linking the NCLEX-RN
Examination to Practice
• Assess central venous access devices.
• Perform calculations needed for medication administration.
• Evaluate client response to medication.
• Educate the client about medications.
• Prepare and administer medications using the rights of medication administration.
• Review pertinent data prior to medication administration (e.g., contraindications, lab
results, allergies, potential interactions).
• Participate in the medication reconciliation process.
• Titrate the dosage of medication based on assessment and ordered parameters.
• Handle and maintain medication in a safe and controlled environment.
• Evaluate the appropriateness and accuracy of the medication order for the client.
• Handle and/or administer high-risk medications.
• Monitor intravenous infusions and maintain the site.
• Administer medications for pain management.
• Handle and/or administer controlled substances within regulatory guidelines.
• Administer parenteral nutrition and evaluate the client’s response.
Related content includes, but is not limited to, the following:
• Adverse effects/contraindications/side effects/interactions
• Blood and blood products
• Central venous access devices
• Dosage calculation
• Expected actions/outcomes
• Medication administration
• Parenteral/intravenous therapies
• Pharmacological pain management
• Total parenteral nutrition (TPN)
Reduction of Risk Potential
This subcategory assesses your ability to reduce the likelihood that clients will develop
complications or health problems related to existing conditions, treatments, or procedures.
REDUCTION OF RISK POTENTIAL
Related Activity Statements from the 2017 RN Practice Analysis: Linking the NCLEX-RN
Examination to Practice
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• Assess and respond to changes and/or trends in the client’s vital signs.
• Perform diagnostic testing (e.g., electrocardiogram, oxygen saturation, glucose
monitoring).
• Monitor the results of diagnostic testing and intervene as needed.
• Obtain blood specimens (e.g., venipuncture, venous access device, central line).
• Obtain specimens other than blood for diagnostic testing (e.g., wound, stool, urine).
• Insert, maintain, or remove a nasal/oral gastrointestinal tube.
• Insert, maintain, or remove a urinary catheter.
• Insert, maintain, or remove a peripheral intravenous line.
• Maintain a percutaneous feeding tube.
• Apply and/or maintain devices used to promote venous return (e.g., antiembolic
stockings, sequential compression devices).
• Use precautions to prevent injury and/or complications associated with a procedure or
diagnosis.
• Evaluate the client’s responses to procedures and treatments.
• Recognize trends and changes in the client’s condition and intervene as needed.
• Perform focused assessments.
• Educate the client about treatments and procedures.
• Provide preoperative or postoperative education.
• Provide preoperative care.
• Manage the client during a procedure with moderate sedation.
• Manage the client following a procedure with moderate sedation.
Related content includes, but is not limited to, the following:
• Changes/abnormalities in vital signs
• Diagnostic tests
• Laboratory values
• Potential for alterations in body systems
• Potential for complications of diagnostic tests/treatments/procedures
• Potential for complications from surgical procedures and health alterations
• System-specific assessments
• Therapeutic procedures
Physiological Adaptation
This subcategory assesses your ability to manage and provide care for clients with acute, chronic,
or life-threatening physical health conditions.
PHYSIOLOGICAL ADAPTATION
Related Activity Statements from the 2017 RN Practice Analysis: Linking the NCLEX-RN
Examination to Practice
• Perform diagnostic testing (e.g., electrocardiogram, oxygen saturation, glucose
monitoring).
• Monitor the results of diagnostic testing and intervene as needed.
• Obtain blood specimens (e.g., venipuncture, venous access device, central line).
• Obtain specimens other than blood for diagnostic testing (e.g., wound, stool, urine).
• Insert, maintain, or remove a nasal/oral gastrointestinal tube.
• Insert, maintain, or remove a urinary catheter.
• Insert, maintain, or remove a peripheral intravenous line.
• Maintain a percutaneous feeding tube.
• Apply and/or maintain devices used to promote venous return (e.g., antiembolic
stockings, sequential compression devices).
• Use precautions to prevent injury and/or complications associated with a procedure or
diagnosis.
• Evaluate the client’s responses to procedures and treatments.
• Recognize trends and changes in the client’s condition and intervene as needed.
• Perform focused assessments.
• Educate the client about treatments and procedures.
• Provide preoperative or postoperative education.
• Provide preoperative care.
• Manage the client during a procedure with moderate sedation.
• Manage the client following a procedure with moderate sedation.
Related content includes, but is not limited to, the following:
• Changes/abnormalities in vital signs
• Diagnostic tests
• Laboratory values
• Potential for alterations in body systems
• Potential for complications of diagnostic tests/treatments/procedures
• Potential for complications from surgical procedures and health alterations
• System-specific assessments
• Therapeutic procedures
Physiological Adaptation
This subcategory assesses your ability to manage and provide care for clients with acute, chronic,
or life-threatening physical health conditions.
PHYSIOLOGICAL ADAPTATION
Related Activity Statements from the 2017 RN Practice Analysis: Linking the NCLEX-RN
Examination to Practice
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• Assist with invasive procedures (e.g., central line, thoracentesis, bronchoscopy).
• Implement and monitor phototherapy.
• Maintain optimal temperature of the client.
• Monitor and care for clients on a ventilator.
• Monitor and maintain devices and equipment used for drainage (e.g., surgical wound
drains, chest tube suction, negative pressure wound therapy).
• Perform and manage care of the client receiving peritoneal dialysis.
• Perform suctioning.
• Perform wound care and/or dressing change.
• Provide ostomy care and/or education (e.g., tracheal, enteral).
• Provide pulmonary hygiene (e.g., chest physiotherapy, incentive spirometry).
• Provide postoperative care.
• Manage the care of the client with a fluid and electrolyte imbalance.
• Monitor and maintain arterial lines.
• Manage the care of a client with a pacing device.
• Manage the care of a client on telemetry.
• Manage the care of a client receiving hemodialysis or continuous renal replacement
therapy.
• Manage the care of a client with an alteration in hemodynamics, tissue perfusion, and/or
hemostasis.
• Educate the client regarding an acute or chronic condition.
• Manage the care of a client with impaired ventilation/oxygenation.
• Evaluate the effectiveness of the treatment plan for a client with an acute or chronic
diagnosis.
• Perform emergency care procedures.
• Identify pathophysiology related to an acute or chronic condition.
• Recognize the signs and symptoms of client complications and intervene.
Related content includes, but is not limited to, the following:
• Alterations in body systems
• Fluid and electrolyte imbalances
• Hemodynamics
• Illness management
• Medical emergencies
• Pathophysiology
• Unexpected response to therapies
Exam Layout
The percentage of test questions assigned to each Client Needs category and subcategory of the
NCLEX-RN Test Plan is based on the results of the Report of Findings from the 2017 RN Practice
Analysis: Linking the NCLEX-RN® Examination to Practice (NCSBN, 2018) and expert judgment
provided by members of the NCLEX-RN Examination Committee. The following reflects the
distribution of content from each category and subcategory.
NCLEX-RN TEST PLAN BREAKDOWN
Client Needs Categories and
Subcategories
Percentage of Items from Each
Category/Subcategory
• Implement and monitor phototherapy.
• Maintain optimal temperature of the client.
• Monitor and care for clients on a ventilator.
• Monitor and maintain devices and equipment used for drainage (e.g., surgical wound
drains, chest tube suction, negative pressure wound therapy).
• Perform and manage care of the client receiving peritoneal dialysis.
• Perform suctioning.
• Perform wound care and/or dressing change.
• Provide ostomy care and/or education (e.g., tracheal, enteral).
• Provide pulmonary hygiene (e.g., chest physiotherapy, incentive spirometry).
• Provide postoperative care.
• Manage the care of the client with a fluid and electrolyte imbalance.
• Monitor and maintain arterial lines.
• Manage the care of a client with a pacing device.
• Manage the care of a client on telemetry.
• Manage the care of a client receiving hemodialysis or continuous renal replacement
therapy.
• Manage the care of a client with an alteration in hemodynamics, tissue perfusion, and/or
hemostasis.
• Educate the client regarding an acute or chronic condition.
• Manage the care of a client with impaired ventilation/oxygenation.
• Evaluate the effectiveness of the treatment plan for a client with an acute or chronic
diagnosis.
• Perform emergency care procedures.
• Identify pathophysiology related to an acute or chronic condition.
• Recognize the signs and symptoms of client complications and intervene.
Related content includes, but is not limited to, the following:
• Alterations in body systems
• Fluid and electrolyte imbalances
• Hemodynamics
• Illness management
• Medical emergencies
• Pathophysiology
• Unexpected response to therapies
Exam Layout
The percentage of test questions assigned to each Client Needs category and subcategory of the
NCLEX-RN Test Plan is based on the results of the Report of Findings from the 2017 RN Practice
Analysis: Linking the NCLEX-RN® Examination to Practice (NCSBN, 2018) and expert judgment
provided by members of the NCLEX-RN Examination Committee. The following reflects the
distribution of content from each category and subcategory.
NCLEX-RN TEST PLAN BREAKDOWN
Client Needs Categories and
Subcategories
Percentage of Items from Each
Category/Subcategory
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Safe and Effective Care
Environment
• Management of Care
• Safety and Infection Control
17–23%
9–15%
Health Promotion and Maintenance 6–12%
Psychosocial Integrity 6–12%
Physiological Integrity
• Basic Care and Comfort
• Pharmacological and Parenteral
Therapies
• Reduction of Risk Potential
• Physiological Adaptation
6–12%
12–18%
9–15%
11–17%
What to Expect on the Exam
The NCLEX-RN exam uses consistent language and universal terminology that is appropriate
for an entry-level nurse. The exam is not focused on specific areas of nursing. Remember, the
NCLEX-RN exam is a computer adaptive test and the items are selected based on your ability.
The exam adheres to the test plan’s content area percentages, so the items fall across all difficulty
levels to cover all of the areas of the test plan. You may receive a question that seems to be very
similar to a question received earlier in the examination. There are a variety of reasons for this,
but do not assume this has occurred because a previous similar item was answered incorrectly.
Just continue to select the answer for each question that you believe to be correct.
All of the items on the exam are written at an application or higher level of cognitive ability,
which will require you to utilize problem solving skills to select the correct answer. According to
the NCSBN, the items to which you will respond come in various formats. There is no established
percentage of questions that will be in an alternative format. Again, the computer selects items
based only on your ability.
The use of common terminology is important to provide consistency in the language for the
test taker. Therefore, it is essential to become familiar with the terminology used throughout the
NCLEX-RN examination. The following is a terminology list with the definitions that have been
obtained from the 2019 NCLEX-RN Test Plan.
• Client: Individual, family, or group that includes significant others and populations
• Prescription: Orders, interventions, remedies, or treatments ordered or directed by an
authorized primary health care provider
• Primary Health Care Provider: Member of the health care team (usually a medical
physician or other specialty [e.g., surgeon or nephrologist], nurse practitioner, etc.)
licensed and authorized to formulate prescriptions on behalf of the client
• Unlicensed Assistive Personnel (UAP): Any unlicensed personnel trained to function in
a supportive role, regardless of title, to whom a nursing responsibility may be delegated.
Need-to-Know Pharmacology
The NCSBN does not have a specific list of medications available to study. However, for
consistency, the NCLEX-RN exam primarily uses generic medication names only, and some
items may refer to the classification of medications. Therefore, it is important to familiarize
yourself with the generic names of the medications and have a basic understanding of the
classifications for commonly used prescriptions.
On a positive note, the prefixes and suffixes of generic drugs tend to follow a pattern that will
make it easier to review and remember them. An understanding of their purpose, expected action,
route of administration, antidotes, adverse effects, contraindications, side effects, and interactions
will keep your client safe.
Environment
• Management of Care
• Safety and Infection Control
17–23%
9–15%
Health Promotion and Maintenance 6–12%
Psychosocial Integrity 6–12%
Physiological Integrity
• Basic Care and Comfort
• Pharmacological and Parenteral
Therapies
• Reduction of Risk Potential
• Physiological Adaptation
6–12%
12–18%
9–15%
11–17%
What to Expect on the Exam
The NCLEX-RN exam uses consistent language and universal terminology that is appropriate
for an entry-level nurse. The exam is not focused on specific areas of nursing. Remember, the
NCLEX-RN exam is a computer adaptive test and the items are selected based on your ability.
The exam adheres to the test plan’s content area percentages, so the items fall across all difficulty
levels to cover all of the areas of the test plan. You may receive a question that seems to be very
similar to a question received earlier in the examination. There are a variety of reasons for this,
but do not assume this has occurred because a previous similar item was answered incorrectly.
Just continue to select the answer for each question that you believe to be correct.
All of the items on the exam are written at an application or higher level of cognitive ability,
which will require you to utilize problem solving skills to select the correct answer. According to
the NCSBN, the items to which you will respond come in various formats. There is no established
percentage of questions that will be in an alternative format. Again, the computer selects items
based only on your ability.
The use of common terminology is important to provide consistency in the language for the
test taker. Therefore, it is essential to become familiar with the terminology used throughout the
NCLEX-RN examination. The following is a terminology list with the definitions that have been
obtained from the 2019 NCLEX-RN Test Plan.
• Client: Individual, family, or group that includes significant others and populations
• Prescription: Orders, interventions, remedies, or treatments ordered or directed by an
authorized primary health care provider
• Primary Health Care Provider: Member of the health care team (usually a medical
physician or other specialty [e.g., surgeon or nephrologist], nurse practitioner, etc.)
licensed and authorized to formulate prescriptions on behalf of the client
• Unlicensed Assistive Personnel (UAP): Any unlicensed personnel trained to function in
a supportive role, regardless of title, to whom a nursing responsibility may be delegated.
Need-to-Know Pharmacology
The NCSBN does not have a specific list of medications available to study. However, for
consistency, the NCLEX-RN exam primarily uses generic medication names only, and some
items may refer to the classification of medications. Therefore, it is important to familiarize
yourself with the generic names of the medications and have a basic understanding of the
classifications for commonly used prescriptions.
On a positive note, the prefixes and suffixes of generic drugs tend to follow a pattern that will
make it easier to review and remember them. An understanding of their purpose, expected action,
route of administration, antidotes, adverse effects, contraindications, side effects, and interactions
will keep your client safe.
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Units of Measurements and Laboratory Values
The NCLEX-RN exam items currently include a combination of international systems of units
(SI) and imperial measurement options used in the nursing profession, so the unit of measurement
presented in the item will be familiar to the candidate. According to the 2019 NCLEX-RN Test
Plan, you must be able to identify the following laboratory values:
• ABGs (pH, PO2, PCO2, SaO2, HCO3)
• BUN
• Cholesterol (total)
• Creatinine
• Glucose
• Glycosylated hemoglobin (HgbA1c)
• Hematocrit
• Hemoglobin
• INR
• Platelets
• Potassium
• PT
• PTT
• aPTT
• Sodium
• WBC
Item Formats
The NCLEX-RN examination includes a variety of item formats, including:
• Multiple-choice
• Multiple-response (select more than one correct answer from a given list)
• Fill-in-the-blank calculation
• Hot spots (click on the correct spot on a given image)
• Exhibits
• Ordered-response items (sort a given list of items into the correct order)
• Audio and graphic items
All item types may include multimedia, such as charts, tables, graphics, and audio. All answers
to alternative items will be scored either as right or wrong—there is no partial credit given.
TOP 10 STRATEGIES FOR CHOOSING THE CORRECT
ANSWER
1. Familiarize yourself with the information on the National Council of State Boards of
Nursing website (www.ncsbn.org). Everything that you need to understand—from
registering for the exam to the structure of the exam—is available to you online.
2. Do not forget that the NCLEX-RN is a test to measure the competencies needed to
ensure public protection and to assess your ability to perform safely and effectively as a
newly licensed entry-level RN. Therefore, you must be familiar with the use of
prioritization techniques. Pay attention to the words used in the questions. Bolded
words in the questions such as best, most, essential, first, priority, immediately,
highest, and initial are a signal that this a priority question. All of the answers will be
The NCLEX-RN exam items currently include a combination of international systems of units
(SI) and imperial measurement options used in the nursing profession, so the unit of measurement
presented in the item will be familiar to the candidate. According to the 2019 NCLEX-RN Test
Plan, you must be able to identify the following laboratory values:
• ABGs (pH, PO2, PCO2, SaO2, HCO3)
• BUN
• Cholesterol (total)
• Creatinine
• Glucose
• Glycosylated hemoglobin (HgbA1c)
• Hematocrit
• Hemoglobin
• INR
• Platelets
• Potassium
• PT
• PTT
• aPTT
• Sodium
• WBC
Item Formats
The NCLEX-RN examination includes a variety of item formats, including:
• Multiple-choice
• Multiple-response (select more than one correct answer from a given list)
• Fill-in-the-blank calculation
• Hot spots (click on the correct spot on a given image)
• Exhibits
• Ordered-response items (sort a given list of items into the correct order)
• Audio and graphic items
All item types may include multimedia, such as charts, tables, graphics, and audio. All answers
to alternative items will be scored either as right or wrong—there is no partial credit given.
TOP 10 STRATEGIES FOR CHOOSING THE CORRECT
ANSWER
1. Familiarize yourself with the information on the National Council of State Boards of
Nursing website (www.ncsbn.org). Everything that you need to understand—from
registering for the exam to the structure of the exam—is available to you online.
2. Do not forget that the NCLEX-RN is a test to measure the competencies needed to
ensure public protection and to assess your ability to perform safely and effectively as a
newly licensed entry-level RN. Therefore, you must be familiar with the use of
prioritization techniques. Pay attention to the words used in the questions. Bolded
words in the questions such as best, most, essential, first, priority, immediately,
highest, and initial are a signal that this a priority question. All of the answers will be
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Subject
National Council Licensure Examination