Types of questions on the NCLEX

** KEY WORDS**: You must practice picking out the key words. Every word is important. The words are not there to fill in space. Each word is a clue or information to help you pick out the correct answer. Note pt. age (pre-school, school age, young, old, etc…), note stages of development, trimester, environment, any complications, stages of the disease, right vs. left side, newly diagnosed, acute vs. chronic. All of that information will have you approaching the pt. care a different way.

Example: Your patient is scheduled for a surgical procedure. You, the OR nurse is monitoring the physiological integrity of the patient. Which of the following activities is most appropriate?

choice_1>Determine client contentment with care received.

choice_2>Assess client’s emotional status.

choice_3>Monitor asepsis in the surroundings.

choice_4>Calculate fluid loss and its effects.

Your key word within your scenario is physiological, any answer that does not deal with the physiological integrity of the client is wrong. Choice 1 & 2 are emotional/psychological answers. It’s nice to monitor asepsis but not in the surroundings.

** Remember that there are key words within your answer choices as well. For example; answer choices that have words like “all”, “always” or “every”.

1. Knowledge questions: The ones that require you to know lab values, pathophysiology and etc…. There is not much you can do with those, which is why it’s vital that you know your material. You either know it or you don’t. Make an educational guess - when you have absolutely no clue.

2. Assessment vs. Implementation: Pay attention and make sure you understand what the question is asking. A. Is it asking “what you should do FIRST”? If you have not assessed within your scenario than you need to assess first.

ORB. Is the question asking “what should you implement”?

3. Priority questions: A. Who to DC home first? – whoever is least critical and or has a chronic disease. Think about it, they’ve had this disease

for years; there is not much you can do for them. This is also the same type of patient you would give to the specialized nurse who is floating to the Med-surge floor. Give them patients they would have dealt with on their floor or patients with predictable outcome.

B. Who to see first? (the triage questions) – Pay attention to ABC, most critical, most recent admissions. Example: burn to the face, hemophiliac, object up the nose, etc…..

4. Delegation questions: A. RN – sees all new admissions, post-ops, critical and unstable pts.B. LPN- sees old admissions, pt. days post-op, stable patients with predictable outcome.C. UAP- assist and reports back. Does nothing that requires judgment. Make sure they have the skill to do the assign

task.

5. Safety questions: question on safety can come from many different sections. For example; checking for allergies with diagnostic tests, fall precaution with medication that decreases LOC, child safety with the car seat, restraints, sharp containers, risk for suicide, removing pt. from abuser, etc….**This is definitely where you want to pick out your key

words.** I promise you that somewhere within your scenario there will be a key word concerning safety. DON’T MISS IT!!!!!

6. Psychiatric questions: Those are probably the easiest; usually everything you need to answer the question is within your scenario. Minimal knowledge is needed. Process of elimination is great for Psych questions.

A. The patient doesn’t have to be crazy for it to be a psych question. For example; you may have a patient who refuses to look at a new colostomy.

B. Eliminate any answers that have you 1. Ignoring the patient question 2. Giving your opinion “I think, I feel, I, I, I, I, I” 3. Telling the patient all will be well, or “that MD is the best” 4. Asking the patient “why” 5. Feeding into pt. delusional thoughts

C. Good answers: 1. Have you staying with the patient, providing support, setting limits and making contracts 2. Asking open-ended questions. For example; “tell me how that makes you feel”

3. Remain non-judgmental, orienting pt. to reality, involve pt. in decision making, positive reinforcement, maintain therapeutic relationship and Milieu environment.

D. Risk for suicide and risk for safety is always a priority.

6. Isolation / Infection control questions: Pay attention as to what disease the patient has. How will you catch that? Is it respiratory, do they have diarrhea? A. Who should be roommates? Patients with same diseases. B. Immunosuppressed pt. cannot room with anyone with an outbreak C. Pt. with outbreak cannot roommate with anyone. D. Must report communicable diseases.

7. Teaching questions: Teaching is important because it’s a preventative measure and it decreases risks for complications. Teaching questions can come from many different sections. For example, teaching before discharge or pre-op teaching. Remember to use appropriate methods for teaching. Teaching should always take place pre-op. Check pt. readiness to learn. Teaching includes facts not opinions.

*** Always assess the patient before checking the machine*****Deal with what is happening within the scenario. Stick with what they tell you, don’t think what if…..***

Tip:

Answering NCLEX-style questions takes practice and skill. Try these tips to see if these help you to score better:

Read the question carefully, looking for key words (such as "first", "priority", "greatest", "best", etc.) and then read each of the responses separately.

Be sure to select the response that best answers the question being asked (and never read anything into a question!) Remember that the first step of the nursing process is assessment; when the question is asking for the initial nursing action, always look

to see if there is a relevant assessment answer. Focus on the client's safety when there doesn't seem to be an urgent physiologic need. If it's a multiple select question, treat each response as a true/false statement - if it is true, then you can be fairly confident that it is one

of the correct responses. avoid choices with the answers "all" "always" "never" or "none". Nothing is ever a definite in Science. look for answers that are different. If three answers say the same thing but in different words, choose the answer that is

different. when given choices that are pharmacologically based or non pharmacologically based, choose the non pharmacological

intervention. It is more often then not, the correct answer.