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Only one goal is served by the National Council Licensure Examination for Registered Nurses (NCLEX-RN® exam): to assess whether or not you are fit to practice as an entry-level nurse. It’s very different from any nursing school test you’ve ever taken. The NCLEX-RN®, unlike nursing school exams, examines your ability to apply and analyze what you’ve learned in the classroom. When it comes to making nursing decisions, you’ll be judged on your ability to apply critical thinking skills.

The “Meeting Client Needs” paradigm guides the NCLEX-RN® exam. In total, there are four primary categories and eight subcategories in the list. Students in many nursing programs are required to study distinct medical, surgical, pediatric, psychiatric/neurological, and obstetric classes. In contrast, the NCLEX-RN® exam integrates all of the material.

The most common question type is a multiple-choice one with four possible answers; however, other question types are available. In addition to multiple-choice and answer choices, there are also fill-in-the-blank and hot spot questions as well as charts and exhibits. Nursing content is interwoven into all questions.

Consider the following dilemma:

After an uncomplicated delivery of a 9 lb. 8 oz. baby boy, a 23-year-old mother with insulin-dependent diabetes mellitus (IDDM) is brought back to the recovery room. According to the nurse’s expectations, the patient’s blood sugar should be

rise and fall continue to move in a static pattern.
Is this a question for an obstetrician or a question for a doctor or surgeon? Considering diabetes pathophysiology as well as labor and delivery concepts is necessary for selecting the correct answer (2).

CAT stands for “computer adaptive test,” which is a testing format that adapts to your responses to the questions you’ve answered in real time. The CAT ensures that the questions are neither too difficult nor too easy for you. You might expect your first question to be below the required proficiency level. You get a somewhat more challenging question if you answer it properly. An easier question is selected if an incorrect answer is given. The computer is able to measure your degree of proficiency if you keep doing this throughout the test.

Needs of NCLEX-RN Candidate

NCLEX-RN® test questions are divided into four broad categories based on the needs of potential clients. Take a look at this:

Enviroment that is both safe and effective
In the first category of client needs, Safe and Effective Care Environment, there are two concepts:

The NCLEX-RN® exam has 17-23% of its questions on management of care. This section includes acts such as Advanced Directives, Advocacy, Case Management, Confidentiality and Continuity of Care, Quality Improvement and Delegation, Establishing Priorities, Ethical Practice, Informed Consent, Legal Responsibilities, and Referrals.

About nine to fifteen percent of exam questions pertain to infection prevention and control. Accident Prevention, Error Prevention, Hazardous Materials, Surgical Asepsis, Standard Precautions, and the Use of Restraints are all examples of nursing activities that can be taken to avoid harm.

Cultivating and maintaining good health
Health Promotion and Maintenance is the second client need category. Only 6% to 13% of the exam is comprised of these kind of questions. Aging, Prenatal/Intrapartum/Postpartum Care, Newborn Care, Stages and Transitions of Development and Transitions of Disease Prevention and Disease Screening and Lifestyle Choices Physical Assessment Techniques Health Promotion Program High Risk Behaviors and Self-Care Nursing actions are tested.


Psychosocial Integrity is the third type of client need to be considered. In the exam, it makes up between 6-12 percent of the questions and tested actions include grieving and loss and mental health concepts as well as the spiritual influence on health, sensory/perceptual alterations and stress management as well as support systems as well as therapeutic communication, chemical dependency, behavioral interventions, and crisis intervention.


Physiological Integrity is the final category of client needs listed here. There are four main ideas here:

NCLEX-RN® Basic Care and Comfort questions make about 6% to 13% of the exam’s total questions. Assistive devices, elimination, mobility, nonpharmacological comfort interventions, nutrition and oral hydration, personal hygiene, and rest and sleep are all included in this subsection of nursing care.

12-18% of the exam is devoted to topics in Pharmacology and Parenteral Therapy. Nursing actions that have been tested include Adverse Effects, Contraindications, Blood and Blood Products, Central Venous Access Devices, Chemotherapy, Expected Effects, Intravenous Therapy, Medication Administration, Pharmacological Pain Management, Total Parenteral Nutrition, and Dosage Calculation.

9-15 percent of the exam is dedicated to reducing the risk of failure. There are a wide range of tested nursing actions that include diagnostic tests, laboratory values, the potential for complications from surgical procedures and health alterations, as well as therapeutic measures.

Eleven to one-sevenths of the exam is taken up by Physiological Adaptation. For example, it has been shown to be effective in dealing with systemic changes in the body, electrolyte imbalances, hemodynamics, life-threatening situations, and unexpected responses to treatments, among other things.

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