Understanding the NCLEX® Test Plan

You made it to nursing school. Congratulations! You will be learning a lot of nursing knowledge and practicing a lot of skills necessary to be a competent, safe nurse.

Nursing school will prepare you to function as a novice nurse, but NCLEX® will test your knowledge in order to make sure you are a safe nurse. The most important test of your life will be the one you take after you graduate from nursing school. So why wait until you graduate before you visit the National Council of Board of Nursing’s (NCSBN) website? You will find a valuable learning tool on that site: The NCLEX® test plan!

For those of you who will be taking NCLEX® after April 2016, a new test plan will be in place. The good news is that the test plan changed very little from the last test plan. So don’t fear! You have been learning what you need to know to pass the test.

The content of the NCLEX®-RN Test Plan is organized into four major Client Needs categories. Two of the four categories are divided into subcategories. So you basically have 8 client needs categories. Based on a practice analysis process, NCSBN develops the percentage range that each category will appear on your NCLEX® exam. Then related content is provided. But NOTE: NCSBN says “Related content includes but is not limited to…

Safe and Effective Care Environment

Management of Care 17-23% Safety and Infection Control 9-15% Health Promotion and Maintenance 6-12% Psychosocial Integrity 6-12%

Physiological Integrity

Basic Care and Comfort 6-12% Pharmacological and Parenteral Therapies 12-18% Reduction of Risk Potential 9-15% Physiological Adaptation 11-17% NCSBN (2015, p. 3).

Integrated Processes

Integrated processes are fundamental to nursing practice and are incorporated throughout the Client Needs categories. According to NCSBN (2015) these include:

Nursing Process – a scientific, clinical reasoning approach to client care that includes assessment, analysis, planning, implementation and evaluation.

Caring – interaction of the nurse and client in an atmosphere of mutual respect and trust. In this collaborative environment, the nurse provides encouragement, hope, support and compassion to help achieve desired outcomes.

Communication and Documentation – verbal and nonverbal interactions between the nurse and the client, the client’s significant others and the other members of the health care team. Events and activities associated with client care are recorded in written and/or electronic records that demonstrate adherence to the standards of practice and accountability in the provision of care.

Teaching/Learning – facilitation of the acquisition of knowledge, skills and attitudes promoting a change in behavior.

Culture and Spirituality – interaction of the nurse and the client (individual, family or group, including significant others and population) which recognizes and considers the client-reported, self-identified, unique and individual preferences to client care, the applicable standard of care and legal instructions (p3).

Using the NCLEX® Test Plan to Study

When students are having trouble passing NCLEX, they will call and ask us how to improve in the category in which they were below the passing standard. They do not know what to study. By using the NCLEX test plan as a study tool while in school you will learn what you need to know to be one step closer to passing NCLEX.

So, let’s say you are studying nursing care of the client diagnosed with diabetes. What do you need to know? Let’s look at the 8 client needs categories to get some examples.

Management of Care

Sample Question: Who could the RN delegate FSBS’s to? Sample Answer: LPN

Sample Question: With which multidisciplinary team members will the RN collaborate? Sample Answer: Primary healthcare provider, pharmacist, case manager, dietician.

Safety and Infection Control

Sample Question: How does the client need to dispose of used syringes and needles at home? Sample Answer: Plastic container with cap.

Health Promotion and Maintenance

Sample Question: What health promotion activities could be taught to people to reduce the risk of diabetes? Sample Answer: Proper diet and exercise. Lose weight.

Psychosocial Integrity

Sample Question: What coping mechanisms might be helpful for this client? Sample Answer: Avoid negative feelings. Walk, dance, do something. Talk to someone. Pray.

Basic Care and Comfort

Sample Question: Does the client need any assistive devices? Sample Answer: Glasses? Walker?

Sample Question: What kind of diet does the client need? Sample Answer: ADA – include what it entails.

Pharmacology

Sample Question: What do I need to know about the different types of insulin? Sample Answer: Include all types of insulin and oral hypoglycemic medications discussed in class.

Sample Question: What are common oral hypoglycemic? Sample Answer: Include all types of insulin and oral hypoglycemic medications discussed in class.

Reduction of Risk Potential

Sample Question: What does the client need to do to decrease the risk of foot infection? Sample Answer: Wear comfortable shoes at all times. Cut toe nails straight across. Inspect feet daily. Dry completely between toes.

Physiological Adaptation

Sample Question: Management of DKA Sample Answer: 2 IVs of NS. IV insulin, ABGs, FSBS hourly, VS hourly. Monitor potassium. Cardiac monitoring.

So, this is an example of what you might include under each category. Now obviously there is a lot more that you could add under each one, so have a copy of the detailed test plan readily available so that you can make a complete study guide. You could even make a template of these categories and during your daily reading assignment, ask and answer questions related to each category. Then during class add additional information that you did not include.

This is one strategy that will help you get the information you need into your long-term memory. Remember, that you need to know this material now, next year, and years from now. So you do not simply need to memorize the information for your test and then forget it. You will see it again . . . on NCLEX®!

October 06

Debra S. McDonough, RN, MSN, EdD