The NCLEX: the ultimate goal for every nursing student—and, the source of constant anxiety, stress, and sleepless nights. Nursing school exams are supposedly modeled after it, giving us multiple-choice questions where there are always two good answers, and we “have to choose the better of the two.”
We are in a constant state of studying and memorizing hundreds of facts at a time, trying to retain as much information as we can for the time when we will eventually take “the big one,” the NCLEX. As a former student and current registered nurse, I can tell you that, with plenty of preparation and planning, you too can pass the NCLEX as I did.
1. The Tools to Use
My school offered an accelerated BSN program that was 22 months long. Each class lasted about 4-8 weeks depending on whether there was a clinical component. We had an exam every other week, and our program required that you meet a 76% benchmark for all of your tests to stay in the program. While I hated studying for hours on end day after day for those two years, it did teach me how to study smarter.
My notes focused on “the big picture” for what we were learning, such as body systems or major nursing concepts, then I re-read and focused on what particular information stood out about that disease or medication, etc. Our program had incorporated ATI into it, so we had this learning tool that taught us content throughout the program. If your school does not use it, I highly suggest using something like this to help you with practice questions, then read the rationales for each question as to why the answer is this one and not the others.
When my program was completed, there was about a 2-3 month lag time between when our conferral date was and when I should have gotten my Authorization To Test for the NCLEX, or ATT. In that time, I made myself keep studying; I never took a break because I knew that I would have a hard time remembering things for when I would sit for the NCLEX. I am someone that needs constant exposure to material for it to be fresh instead of cramming beforehand.
The NCLEX prep tool that my mentor had suggested, and the one I used for 2 months prior to the NCLEX, was UWorld. There are various NCLEX-RN packages to choose from, ranging from 60 days for $139 up to 730 days for $299. I purchased the 90-day $159 package, which included access to the 2,000-plus practice questions, as well as two 75-question self-assessments that gauged my readiness for the NCLEX.
2. It’s All About Strategy
Since I learned mainly content for nursing school using ATI while I was in the program, I felt that UWorld was the only tool I needed to help me with test-taking strategies. It’s impossible to know everything there is to know in the nursing field, but if you have already been exposed to the major concepts during school, all you need is to know how to apply what you’ve learned in practice questions.
What I liked about UWorld was that you can create quizzes for yourself, up to 75 questions at a time, and choose from a variety of subjects and systems. I was averaging at the 68th percentile, and the average for users was about 48th percentile. I loved how, after I answered each question, it would show me the percentage of people who got that question correct—it helped me to keep track of what areas I needed to focus on when I was studying. I would take plenty of time to read the question, sometimes more than once to really grasp what the question was asking, and I did a process of elimination to narrow it down to at least two answers.
I always applied the various prioritization tools, such as ABCs, “life over limb,” acute vs chronic, systemic vs local, etc. Most of the time, questions deal with what is the priority. I tried to always go with my gut and not change my answer, since I knew that with the NCLEX you cannot go back and change any answers. The questions sometimes give you clues, such as what the medication is for, or how the disease process works, which was nice for me to stop stressing out about knowing all the content I could. I did at least 75 questions a day with a mixture of different subjects, sitting down and finishing the entire block at once with as little interruption to mimic the NCLEX, and felt that this was the best way to prepare.
3. The Night Before (and Day Of)
I kept a notebook at my side when I studied and took practice tests and kept a running list of the things that I knew I was struggling with. I studied for two and a half months before I finally took my NCLEX. The day before I took my exam, I didn’t do anymore practice questions.
I had completed about 80% of the QBank on UWorld, and did the two self assessments the week prior to my NCLEX date. Again, it showed I was in the 68th percentile, with a “Very High” chance of passing the NCLEX. When I was in a nursing school, my ATI comprehensive exam said I was 97% likely to pass my NCLEX on the first try as well.
The night before I took my NCLEX, I went through every single note I had set aside for review, roughly a few hundred pages.
I am a visual learner, so I made sure I at least looked at the material I struggled with one more time to make sure it was fresh for the next day. Once I finished that, I made sure I had a healthy dinner and went to bed early, since I knew I wanted to get to the test center at least one hour beforehand (when you register for the NCLEX, they say to be there at least 30 minutes before).
The morning of, I brought with me only my ID, phone, keys, and some healthy snacks and a water to bring with me (our test center had a locker where I could put my stuff). I ate a healthy breakfast and drank plenty of water beforehand, and used the restroom just before going into the test center so that I didn’t need to take any breaks. My exam shut off at 75 questions, so my test took just over an hour to complete.
The single most important thing I told myself over and over again for months on end was: “You know this; just trust yourself.” Anxiety is the greatest threat to thinking clearly, so if you were able to pass nursing school, you already have all the tools you need to do well. Just keep your anxiety level to a minimum and you will do just fine!