The NCLEX-RN® is a comprehensive, computer-adaptive test that all graduates of nursing programs and foreign nurses must pass in order to be licensed as registered nurses in the U. S. It’s not an exam to be taken lightly especially when encountering NCLEX priority questions. However, with good preparation and test-taking strategies, you can definitely master it!
ANSWERING THE QUESTION
Read the stem question and understand what subject or knowledge the question is asking, and determine whether a true or false response stem is needed. Be clear before you look at the options, if not, reword the question using your own words.
KNOW THE BASIC PRINCIPLES IN NURSING PRACTICE
When making a decision, the test taker should base his/her judgment in accordance to the basic principles in nursing practice, and these are the Nursing Process, ABC’s (Airway, Breathing & Circulation) and Maslow’s Hierarchy of Needs.
KNOW THE GENERAL DELEGATION GUIDELINES AND SCOPE OF DUTIES
General Delegation Guidelines
• The most critical patients gets the most qualified nurse
• Do not delegate care of unstable patients
• Discharge the most stable person
• Place the most unstable person in the ICU
• Patient assessment (except obtaining routine vital signs with stable patients)
• Initial, subsequent or emergency • Requires special judgment, knowledge or skill
NOTE FOR INITIAL RESPONSE ACTION
If the question is looking for initial action (ex. which intervention would the nurse implement first?) and all choices are correct, you need to select an option that is best for the client’s condition. Look for the best answer, not the right answer.
GLOBAL AND ABSOLUTE WORDS
Take caution about answers that include global and absolute words such as always, never, only, all, none, everyone, must. There are very few instances in which correct answer uses these words.
Broadest and most comprehensive answer. Choose an answer that includes all the others. If all answers seem to be correct and applicable, choose the one that includes all the choices in it. One answer is better than all the others because it includes them.
USE THE PROCESS OF ELIMINATION
Using your clinical knowledge and critical thinking skills, eliminate first the incorrect options and choose the best answer. Eliminating any options that you are 100% sure are wrong will improved your odds of choosing the correct answer choice.
Understand first the subject or topic of the question and answer each option as a true or false statement – whether the option is related to the question topic or not. There will be at least 2 correct answers.
LIST THE ORDER OF PRIORITY / SEQUENCE ORDER
You are required to move the answers into the appropriate order depending on the type of question. Some questions ask a situational approach in accordance of their priority (ex. who would you assess first from the following clients), application of nursing process (ADPIE), nursing procedures (ex. removing personal protective equipment), and nursing diagnosis (actual, wellness, and risk).
KNOW WHEN TO NOTIFY THE PHYSICIAN
Before choosing to notify the physician, you must first ask yourself some questions:
• Did I assessed the client?
• Do I need to provide an intervention that is outside the scope of duty of a registered nurse (RN)?
• Does the client have an immediate need but requires an action of a physician?
CHOOSE AN IDEAL (BOOK BASED) ANSWER, NOT THE REAL-WORLD ANSWER
You must perceive the NCLEX-RN® as a perfect hospital or place wherein all clinical equipment and workforce are available (unless the question intends to clear them), and provide care that is based by the book. You must not select an answer that is based from your own clinical experience that contradicts to the ideal answer.
There may be more tips and guides when answering NCLEX priority questions, however, with proper engagement with your study and making the test-taking strategies indicated above as an addition or part of your learning tool, there is no doubt that you will have a high percentage of succeeding and passing the exam. You must keep in mind that NCLEX-RN is a pass or fail exam, it really doesn’t make a huge difference if you pass and shut down with 75 question or even with 265 question. Almost 90% of recruitment representatives will never ask on what number question you’ve been shut off. Once you pass, that’s it! You are now set for licensure in your chosen state and ready to work as a Registered Nurse! For those taking the NCLEX exam soon, I wish you all the very best!