The NCLEX-PN® exam is not divided into separate content areas. It tests integrated nursing content. Many nursing programs are based on the medical model. Students take separate medical, surgical, pediatric, psychiatric, and obstetric classes. On the NCLEX-PN® exam, all content is integrated.
Look at the following question.
Is this an obstetrical question or a medical/surgical question? In order to select the correct answer, (2), you must consider the pathophysiology of diabetes along with the principles of labor and delivery. This is an example of an integrated question.
The NCLEX-PN® exam is organized according to the framework “Client Needs.” There are four major categories of client needs; two of the major categories are further divided for a total of six subcategories. This information is distributed by NCSBN, the developer of the NCLEX-PN® exam.
The first subcategory for this client need is Coordinated Care, which accounts for 13–19 percent of the questions on the exam. Nursing actions that are covered in this subcategory include:
Here is an example of a typical question from the Coordinated Care subcategory:
The correct answer is (2). This client is in stable condition and can be cared for by an LPN/LVN.
Here is another example of a Coordinated Care question:
The correct answer is (3). This is the least stable client.
The second subcategory for this client need is Safety and Infection Control, which accounts for 11–17 percent of the questions on the exam. Nursing actions that are covered in this subcategory include:
Here is an example of a question from the Safety and Infection Control subcategory:
The correct answer is (1). This action will allow the nurse to correctly identify the child and enable the nurse to give the medication on time.
This client need accounts for 7–13 percent of the questions on the exam. Nursing actions that are covered in this category include:
It is important to understand that not everyone described in the questions will be sick, hospitalized, or in a long-term care facility. Some clients may be in a clinic or home-care setting. Some clients may not be sick at all. Wellness is an important concept on the NCLEX-PN® exam. It is necessary for a safe and effective practical/vocational nurse to know how to promote health and prevent disease.
The following is an example of a typical question from the Health Promotion and Maintenance category:
The correct answer is (1). The LPN/LVN is responsible for data collection and should report findings that are abnormal to the supervising RN. Immediate action should be taken, so (2) is incorrect. It is unnecessary to recheck the blood pressure using other equipment (3) or to position the client supine with feet elevated (4).
This client need accounts for 7–13 percent of the questions on the exam. Nursing actions that are covered in this category include:
This is an example of a typical question from the Psychosocial Integrity category:
The correct answer is (3). The nurse should not reinforce abusive behavior. Clients need consistent and clearly defined expectations and limits.
The first subcategory for this client need is Basic Care and Comfort, which accounts for 9–15 percent of the questions on the exam. Nursing actions that are covered in this subcategory include:
The following question is representative of the Basic Care and Comfort subcategory:
The correct answer is (4). A possible complication that can occur after cast application is impaired circulation. All of these answer choices might be included in family teaching, but checking the child’s circulation is the highest priority.
The second subcategory for this client need is Pharmacological Therapies and accounts for 11–17 percent of the questions on the exam. Nursing actions that are covered in this subcategory include:
Because the brand name or trade name of drugs may vary, you should expect to see the use of generic medication names only on the NCLEX-PN® exam.
Try this question from the Pharmacological Therapies subcategory:
The correct answer is (4). The LPN/LVN must notify the physician regarding the client’s allergy to revise the medication order.
The third subcategory for this client need is Reduction of Risk Potential, which accounts for 9–15 percent of the questions on the exam. Nursing actions that are covered in this subcategory include:
This is a an example of a question from the Reduction of Risk Potential subcategory:
The correct answer is (3). Normal blood pH is 7.35–7.45. The lab result indicates diabetic ketoacidosis.
The fourth subcategory for this client need is Physiological Adaptation, which accounts for 9–15 percent of the questions on the exam. Nursing actions that are covered in this subcategory include:
The following is an example of a Physiological Adaptation question:
The correct answer is (2). The nurse’s elbows should be locked, arms straight, with shoulders directly over hands. Incorrect pressure or improperly placed hands could cause injury to the client.
Several processes are integrated throughout the NCLEX-PN® exam. The most important of these is the nursing process.
For the practical/vocational nurse, the nursing process involves data collection, planning, implementation, and evaluation of nursing care. You will help the registered nurse, or other qualified health professional, formulate a plan of nursing care for clients in a variety of settings. As a graduate practical/vocational nurse, you are very familiar with each step of the nursing process and how to assist in writing a care plan using this process. Knowledge of the nursing process is essential to the performance of safe and effective care. It is also essential to answering questions correctly on the NCLEX-PN® exam.
Now we are going to review the steps of the nursing process and show you how each step is incorporated into test questions. The nursing process is a way of thinking. Using it will help you select correct answers.
Data collection. Data collection is the process of establishing and verifying a database of information about the client. This permits you to collaborate in the identification of actual and/or potential health problems. The practical/vocational nurse obtains subjective data (information given to you by the client that can’t be observed or measured by others) and objective data (information that is observable and measurable by others). This data is collected by interviewing and observing the client and/or significant others, reviewing the health history, performing a physical assessment, gathering lab results, and interacting with the registered nurse and members of the health care team.
An example of a data collection test question is:
The correct answer is (1). Glomerulonephritis is an immunologic disorder that is caused by beta-hemolytic Streptococcus. It occurs 21 days after a respiratory or skin infection.
Planning. During the planning phase of the nursing process, the nursing care plan is formulated collaboratively with the registered nurse. Steps in planning include:
Goals are anticipated responses and client behaviors that result from nursing care. Nursing goals are client-centered and measurable, and they have an established time frame. Expected outcomes are the interim steps needed to reach a goal and the resolution of a nursing diagnosis. There will be multiple expected outcomes for each goal. Expected outcomes guide the practical/vocational nurse in planning interventions.
This is an example of a planning question:
The correct answer is (2). Hypokalemia and hypomagnesemia commonly occur after repeated vomiting.
Implementation. Implementation is the term used to describe the actions that you take in the care of your clients. Implementation includes:
It is important for you to remember that nursing interventions may be:
The NCLEX-PN® exam includes questions that involve all three types of nursing interventions.
Here is an example of an implementation question:
The correct answer is (3). A sterile, gloved hand will cause the least amount of trauma to tissues and will decrease the chances of breaking blisters.
Evaluation. Evaluation measures the client’s response to nursing interventions and indicates the client’s progress toward achieving the goals established in the care plan. You compare the observed results to expected outcomes in collaboration with the registered nurse.
This is an evaluation question:
The correct response is (4). The client’s weight is the most objective outcome measure in the evaluation of this client’s problem.
Several other important processes are integrated throughout the NCLEX-PN® exam. They are:
Caring. As you take the NCLEX-PN® exam, remember that the test is about caring for people, not working with high-tech equipment or analyzing lab results.
Communication and Documentation. For this exam, you are required to understand and utilize therapeutic communication skills with all professional contacts, including clients, their families, and other members of the health care team. Charting or documenting your care and the client’s response is both a legal requirement and an essential method of communication in nursing. On this exam you may be asked to identify appropriate documentation of a client behavior or nursing action.
Teaching/Learning Principles. Nursing frequently involves sharing information with clients and families so optimal functioning can be achieved. You may see questions concerning teaching a client about his or her diet and/or medications.
You might see some questions on the NCLEX-PN® exam that contain graphics (pictures). These questions may include the picture of a client in traction or a pregnant woman’s abdomen. These questions do count, so take them seriously. We have included several questions with graphics in the practice test found in this book and others can be found online at kaptest.com/booksonline.
The more knowledgeable you are about the NCLEX-PN® exam, the more effective your study will be. As you prepare for the exam, keep the content of the test in mind. Thinking like the test maker will enhance your chance of success on the exam.
Are you still thinking about the question involving the pacemaker battery on page 3? What do you think the correct answer is?
The correct answer is (3). These are symptoms of decreased cardiac output. These symptoms occur with pacemaker battery failure. Other symptoms include changes in pulse rate, irregular pulse, and palpitations.
Gastrointestinal symptoms (1) are not found with pacemaker malfunction. The items listed in (2) are not symptoms of pacemaker failure. And although chest pain may occur with decreased output (4), chest pain that radiates to the right arm is suggestive of angina. Headache and diaphoresis are not seen with pacemaker failure.