How to Pass the NCLEX

Isn’t that the ultimate question that everyone wants to know the answer to, “How to Pass the NCLEX?”.

Before you can even begin to think about passing the NCLEX (especially taking the NCLEX after you failed) is to ask yourself if you have these three things?

1. TIME?
2. MONEY?
3. ENERGY?

If any of these three areas are not available in your life, you will have a very difficult time passing.

You need time to study.

If your plate is entirely full already with a job, family, and other house responsibilities, it will be difficult to carve out time to review. Having a supportive family will help lessen the load of your normal responsibilities so that you can focus.

Once you pass the NCLEX, that time you spent studying is no longer an issue. You can now use that time to look for a new job and make more money with a higher skilled job and have career fulfillment. Or spend that time with your family or doing other things you love or have postponed. You’ll finally have time to reorganize the garage, redecorate the bathroom or go surfing three times a week instead of only once a week!

How much time do you need? I suggest that you treat studying for the NCLEX as a part time job. Spend about 20 hours a week preparing for about 8 weeks. If you want more detail on exactly how much time, I wrote a short blog post about it here.

You need money (not always a lot, but some)

Service/Product	Cost
NCLEX Review Course	$125-$2800
NCLEX Content Book	$50-75
Practice Questions	$50-$500
Test Fee	$200
Tutoring	$500-$3000
Total	$425 – $6575

Many students already have taken a review course, have a content review book, and have practice questions that haven’t been used yet. Registering for the NCLEX every time is a minimum of $200. But what is the real cost of not passing? It is lost wages in regards to time you could have been working as a nurse. If you are struggling to pass and you have the time, money and energy, I highly suggest private tutoring with a highly skilled NCLEX tutor to get you organized and accountable. If you aren’t sure who you should tutor with, read about How to Choose a Great NCLEX Tutor.

If you can be extremely disciplined, you really only need one book and one set of practice questions. If the only thing you could afford, then I would suggest the Saunders NCLEX Content Review book. It also comes with over 6000 online practice questions. It will cost you about $60.

You need some energy!

Some motivation! Something to keep your eye on the prize! I printed out a little saying that I look at almost every day in order to keep me focused.

Yes, even Justine, “The NCLEX Tutor” is getting pulled in different directions and I have to try my best to stay focused. For example, in my professional life I am working to build the best team of online NCLEX Nursing Tutors. However, I get asked if I can contribute to other nursing projects from other companies. Even though it sounds like a really cool opportunity, I have to say no.

Another example of chasing multiple rabbits is that I really want to start a Youtube Channel so nursing students can get to know me better. You wouldn’t believe the work that goes into making a video. So what rabbit do I chase? Building a team of Nurse Tutors, making a Youtube Channel, or working with other companies for NCLEX prep materials? I decided building the Tutoring team is the rabbit I’ve decided to chase right now.

Knowing what project I’m going to focus on, gives me the energy to put my best into it. If I had to break up my time into different projects, I would probably not be as energized and each project would suffer.

This little saying keeps me energized for the work I do with students. I love it.

Now that you have carved out some time, put some money aside to pay for the resources, and are energized to get the work done, you can now focus on the three basic principles of passing:

• Have a Plan
• Review content
• Practice questions

I will go into detail to each one of these steps below starting with reviewing content and resources to use.

1. Review Content

1. You must know nursing content. And you need to know a lot. Nurses take care of a variety of patients and at all ages. When you graduate from nursing school, you are a generalist. You don’t have extensive experience in any one area. Instead, you have a very basic knowledge of a variety of problems:
   • Adult health
   • Pediatrics
   • Mental Health
   • Maternity & Newborn

In addition to the basic types of clients you take care of you also have to know about ethical/legal problems, how to prioritize, basic safety issues and infection control precautions.

So, where do you gather all this info? At school obviously. However, as easy as that is said, it always seems like you are asked to read way too much information in a short amount of time. Or your clinicals get cancelled and you never really saw any action of what it’s really like to take care of patients. There’s really no replacement for learning than actually being there physically with the patients and seeing how the nurses interact with the rest of team.

Instead schools will provide V-sims which are “virtual simulations” where you care for a fake patient on a screen. This is not really ideal because you never get to touch the client or see the rest of the care team.

How can really assess a client when you’re not there? You need to touch their skin, hear their voice, test their strengths, watch them walk, even smell them! You know when someone has C. diff when you walk into their room – you can smell it! But how can you smell through a computer? Yes, it’s gross, but an important part of assessment.

Nursing schools will also provide simulation labs, which you are caring for a fake client such as a “high fidelity” mannequin in an artificial setting where you can’t really kill the patient. You get to work with your fellow classmates to care for a client. It’s a step up from doing it on a computer, but still not ideal. One of the reasons that sim labs have become so popular is that there is limited space and time at the hospitals for clinical experiences for students.

Then there are the nursing books. Which as one student told me recently as soon as she looks at the book she “starts to sweat, heart rate goes up and anxiety starts to happen.” Wow. Is that what nursing school has done to people? Personally, I want to be excited when I start a new program or class, not be overwhelmed and dreading it even before it’s started.

So, you have a couple choices when it comes to reviewing content.

1) Be overwhelmed and never really learn anything or

2) Study from a resource that has condensed the material in bite-sized chunks.

Get a Good Book to Review Content

Instead of using all of your nursing books, get one book to review content that includes all the topics. And use that book as a consistent study tool. Then use your nursing books if you need more in-depth knowledge or want to clarify something. If it’s just quick word you need to look up, then just do an internet search.

Since 2014, I have been putting together my “Nugget Pages“. This is my book of the most common content you will get asked about in your nursing school tests and NCLEX. People…it’s taken me 6 years to write! It’s gone through multiple revisions and will continue to go through revisions as I learn more about what students need and how they learn best. I personally love it, but don’t just believe me, read what one of my students has said about it:

What I love about my Nugget Pages is that I organize the content in 3 columns and use bullet points for easier reading. I have over 400 color images in the book for visual learning. And the pharmacology section is organized as tables so that you can quickly scan across to see the important information you need to know.

I left out the fluff and only kept the most important information you need to know in order to make quicker decisions when you are a nurse. You don’t have time to know everything there is to know when you have multiple patients to take care of and limited time. NCLEX even tests you on this, it’s called PRIORITY questions and learning how to prioritize. That’s what the nugget pages are all about, knowing the PRIORITY stuff.

Other Resource Book to Use

Another really good tried and true resource is Saunders Comprehensive Review for the NCLEX. It has more content in it then my Nugget Pages, but is still a great resource to use. They also have over 5000 online practice questions. Saunders is also at the top of their game because so far, it’s the only book that has practice questions for NCLEX Next Gen.

NCLEX Next Gen will have questions on the NCLEX that look more like case studies. Which apparently is what the NCLEX had back in the day. The NCLEX won’t change dramatically at first, but they will sprinkle these case studies throughout the test starting in April 2023. You can read more about the changes to the NCLEX.

There are many more books out there that have condensed the nursing content. However, I don’t specifically recommend any other books besides my Nugget Pages and Saunders. It’s just all so overwhelming and I’m trying to keep things simple. However, as a tutoring service, I adapt to any resource you want to use.

Review Courses

Another great resource is to do a really good review course. Personally, I think all review courses are too short and don’t include a lot of what you might get asked about. And unfortunately it feels like when you do the review course, you are learning everything for the first time.

The good and legitimate review courses are:

• Remar Review
• Klimek Review (live review only)
• Hurst Review
• N-powerment
• Rachel Allen Review

When you do a really good review course, you begin to wonder why you weren’t taught like that by your professors to begin with? I’m starting to think that you should do one of these review courses before you start nursing school. See if you find the nursing content interesting before you waste all your money at nursing school. Review courses cost anywhere from $125-$2800 and are a good investment.

If you do a review course, only do one of them. Don’t start jumping around, especially if you didn’t pass. It may not be a review course problem, you may have an issue with not having enough time or energy.

YouTube Instructors

Another popular way to review content is to watch a Youtube instructor or other video instructor. This is a good route if you enjoy watching someone talk about the content. Unfortunately too many professors are not efficient teachers. You begin to wonder how they ended up in teaching. But that’s beside the point. The point is that you want to learn from someone that makes the content exciting!

Great Youtube Nursing Instructors are:

• Mike from simplenursing.com
• Sarah from registerednursern.com

These instructors have a large amount of content up on Youtube. The problem with video is that there are only so many hours in the day and you would be watching A LOT of video. The content is extensive and can be good if you have trouble understanding certain topics.

As much as I think highly of Mike and Sara, I do have a slight pet peeve with nursing instructors that put up a Mike or Sarah video in nursing class. Why can’t the instructor just teach the content? Isn’t that what they get paid for?

2. Practice Questions

I have worked with some really bright students who have failed the NCLEX. What the heck happened then? Some students get severe anxiety and then bomb the test. Some decided they would be there an hour, 2 hours at the most, and then find themselves there for the entire time with nothing to eat or drink and never once decided to use the bathroom. Bad move.

Be prepared to be at the testing center the entire time. Until at least April 2023, the test is between 75-140 questions and with a maximum testing time of 5 hours. This is for both the RN and PN exam.

You will want to make sure you understand how to answer NCLEX-style questions by using test-taking strategies and analyzing skills (AKA “critical thinking skills”).

People….it’s not rocket science. I promise you that each and every one of you can get good at answering questions in a fairly short amount of time. That is what a lot of my tutoring is all about. Critical thinking is not some mysterious concept that your professors make you think otherwise.

Critical Thinking Skills

Critical thinking skills are asking yourself questions such as:

• Why would I do this?
• What do those signs and symptoms mean?
• What would help in this situation?
• Does their age or gender make any difference in this situation?
• Can this problem wait or should I deal with it right now?

But you can’t really ask those questions if you don’t know stuff. So you have to know nursing content before you can critically think! That’s why reviewing content comes before practicing questions.

Test-Taking Strategies

You will also need to know test-taking strategies. The Saunders review book has a decent list of basic strategies in their book. Kaplan also talks about test-taking strategies in their review course and books. Unfortunately Kaplan is confusing and there are very few good review courses or books that discuss How to Answer NCLEX-style Questions.

It’s really difficult to learn how to answer NCLEX-style questions from a book. Everyone makes differently analyzing mistakes or doesn’t really apply the strategy in the correct way. I can’t tell you how many times I’ve heard “don’t pass the buck” or “they are asking for an intervention and that’s an assessment, I’m not going to choose it, I don’t have the order” These are strategies that are not applied in the right way and really can prevent someone from getting the right answer.

One of the types of question on the NCLEX is the “Select all that apply” question. You can read about how to answer those here. However, it’s common that students misapply the strategies without some personal help.

Resources to Use to Practice NCLEX-Style Questions

If you are in nursing school, use the questions they provide. But wherever you are at in your nursing journey, you’ll need to be practicing questions.

First semester? Practice questions.

About to take an exam at school? Practice questions.

Taking the NCLEX soon? Practice questions.

Failed the NCLEX? Practice questions.

My favorite resources to practice questions are:

• Saunders online questions
• NCLEX Mastery App
• Lippincott book

Other students like to use the LaCharity book, Uworld, and Kaplan.

Many students want to know what kind of scores they should be getting with each of the recourses. Here is my opinion based on hard the questions are:

• Saunders (>80%)
• NCLEX Mastery App, Uworld, and Kaplan (>60%)
• Lippincott, and LaCharity (>70%)

If you jump right into Uworld or NCLEX Mastery App questions and haven’t reviewed content in a while, you will do BAD. So, if you are starting to prepare for the NCLEX, I highly suggest that you review some content first, and then do questions. Saunders are a great resource to use because they ask about more common things. You should do well with Saunders. And if you aren’t, you probably have a major problem with not knowing enough content.

Many students don’t want to review content. They think that they learned it all in nursing school and don’t need to go back and refresh. I definitley have news for you – if you are not passing the NCLEX, you probably don’t know enough content. I don’t care how many questions you practice, you may never pass the NCLEX if you don’t spend some serious time reviewing and memorizing content. Yes, I said memorizing content.

3. Have a Plan

Many students out there have no plan. You randomly start and stop studying. You heard about what someone else is doing and copy that without really thinking about what you need to do personally.

You need a plan! This is also a lot of what my tutoring is about. Getting you on a productive plan that is specific to your needs.

If you have all day to study and practice questions, then you probably need a different plan than a mom that has two young kids in school and has severely limited time. And as unfortunate as it sounds, if you are extremely busy in your personal life with family, a job, and children, it is very unlikely you will have enough time to dedicate to studying for the NCLEX. When taking the NCLEX or preparing for a big milestone in your life, you want to have the time, money, and energy to do it. If any of those three variables are missing, you will become frustrated.

Are you in nursing school? Well that will be a different plan then if you are taking the NCLEX for the 2nd time. Are you a slower learner? Then you are on a different plan then a faster learner. It all just depends on what your circumstances are. That’s why private tutoring is so helpful. It keeps you on a plan and changes it when you need it to.

Basic Study Plan

A basic plan consists of:

• a calendar that shows all the content or topics that you will get tested on
• making sure you are practicing NCLEX-style questions daily
• making sure you are spending just the right amount of time on a topic
• knowing that you have a goal or goals set with a time limit so you have something to reach for
• meeting with someone to show you are accountable and adjusting the plan when needed

The basic topics you need to review and practice questions for are:

• Fundamentals
• Ethical/Legal
• Safety and Infection Control
• Psych
• Pharmacology and Parental therapies (blood, TPN, IV therapy)
• Adult Health (all systems)
• Maternity
• Pediatrics

I made a quick little video with Brainscape about how many questions to do daily. Check it out to help you with your plan.

Conclusion

Assess your situation to make sure you have the time, money and energy to devote to passing. Then once you have that agreed on do the steps below.

1) The 1st step is to get a plan to know what topics to work on daily and when the final test is. Here’s a sample plan I give students.

2) The 2nd step is to choose a resource to review content: choose one book and one review course. Use Youtube instructors to clarify confusing content. I prefer my NCLEX Nursing Nugget Pages book to review content, but you can use whatever you want.

3) The 3rd step is to practice NCLEX-style questions. Use critical thinking skills and test-taking strategies and aim for high scores. Private tutoring really helps to point out any issues you may have with how you answer questions. I like Saunders and the NCLEX Nursing App to practice questions.

Remember that the key to success in your career is focus. If you chase one rabbit, you will catch it! But if you chase two rabbits, you will catch neither.