Patient with SOB, Pneumonia, fall.
You choose one patient. Then, you review each of the 4 categories in the RN-NCLEX Test Plan. Select two categories with the action statements (listed in the test plan) that apply to your patient and what you did. Then you use the other two categories to talk about how you haven't had experience with those areas yet and how you plan to meet them. The template I provided in the announcements helps walk you through it.
4
Adult Health II
Sample
Chamberlain University
NR325 Adult Health II
Dr. Purney
Date
Introduction
This paper aims to evaluate and reflect on the NCLEX-RN® test plan to highlight its strong points and areas that need improvement to ensure clinical practice readiness. This self-assessment is a vital part of the preparation for the transition from nursing education to professional practice… Explain the NCLEX Test Plan using references to support explanation
Importance of the NCLEX-RN® Test Plan in Practice Readiness
The NCLEX-RN® test is an essential tool to guide because it describes the fundamental proficiencies nurses need to provide quality and safe medical services… Continue to explain details.
Importance of Clinical Self-Assessment and Activity Statements
Clinical self-assessments are crucial because they empower nursing students to undertake an active learning process through which they identify their strengths and weaknesses… Define in more details.
Clinical Experience Reflection
During my clinical rotation in an acute care setting, I encountered a challenging scenario involving a post-operative patient who experienced sudden respiratory distress. This experience was pivotal as it required rapid assessment and intervention, emphasizing the critical nature of timely and accurate emergency care. (The scenario needs to be explained)
Categories and Statements of the Activities Practiced
In this scenario, I engaged with two primary NCLEX-RN client need categories: Physiological integrity and a safe and effective care environment…. You will need to discuss the 2 client need categories and describe an activity statement for each client need category that you were able to demonstrate.
Areas for Further Practice
In a broader sense, I understand that I need to be more proficient in some of the same client-need areas…. You will put 2 client needs categories here with 2 activity statements for each category where you see that you need more practice.
Rationale for Category and Activity Selection
These categories and activities are chosen based on their direct effect on patient outcomes and safety. These areas are paramount to the acute care setting…. You will need to determine rationales to selection and use references to support your rationales.
Strategies for Future Clinical Practice
To address these areas, I plan to implement three strategies in my future clinical experiences: List 3 strategies and how you plan to accomplish this here.
Conclusion
This paper was formulated to critically analyze the NCLEX-RN® test plan and its role in directing nursing students to practice readiness during the assessment process, which involved reflection and opportunities for development… Complete a conclusion based on the rubric summarizing the paper and the information that was covered.
References
Flowers, M., Olenick, M., Maltseva, T., Simon, S., Diez-Sampedro, A., & Allen, L. R. (2022). Academic factors predicting NCLEX-RN success. Nursing Education Perspectives, 43(2), 112-114. https://journals.lww.com/neponline/fulltext/2022/03000/academic_factors_predicting_nclex_rn_success.10.aspx
Victor, J., Chavez, L. S., & Podlesney, C. (2021). Do predictor exams really predict readiness for professional nursing practice?. Clinical Simulation in Nursing, 50, 48-54. https://www.sciencedirect.com/science/article/pii/S1876139920300967
At least 2 peer reviewed references and test plan should be used using correct APA formatting
,
NCLEX-RN® Test Plan
Effective April 2023
National Council of State Boards of Nursing, Inc. (NCSBN) | 2023
ii 2023 NCLEX-RN® Test Plan
Mission Statement
NCSBN empowers and supports nursing regulators in their mandate to protect the public.
Purpose and Functions
The purpose of NCSBN is to provide an organization through which nursing regulatory bodies act and counsel together on matters of common interest and concern affecting the public health, safety and welfare, including the development of licensing examinations in nursing.
The major functions of NCSBN include developing the NCLEX-RN® and NCLEX-PN® Examinations, performing policy analysis and promoting uniformity in relationship to the regulation of nursing practice, disseminating data related to NCSBN’s purpose and serving as a forum for information exchange for NCSBN members.
© 2023 National Council of State Boards of Nursing, Inc. (NCSBN)
All rights reserved. NCSBN®, NCLEX®, NCLEX-RN®, NCLEX-PN®, NNAAP®, ORBS®, MACE®, REx-PN®, TERCAP®, Nursys®, Nursys e-Notify®, Safe Student Reports® and Transition to Practice® are registered trademarks of NCSBN and may not be used or reproduced without written permission from NCSBN.
Permission is granted to boards of nursing to use or reproduce all or parts of this document for licensure-related purposes only. Nonprofit education programs have permission to use or reproduce all or parts of this document for educational purposes only. Use or reproduction of this document for commercial or for-profit use is strictly prohibited. Any authorized reproduction of this document shall display the notice: “Copyright by the National Council of State Boards of Nursing, Inc. All rights reserved.” Or, if a portion of the document is reproduced or incorporated in other materials, such written materials shall include the following credit: “Portions copyrighted by the National Council of State Boards of Nursing, Inc. All rights reserved.”
Address inquiries in writing to NCSBN Permissions, 111 E. Wacker Drive, Suite 2900, Chicago, IL 60601-4277. Suggested Citation: National Council of State Boards of Nursing. (2023). 2023 NCLEX-RN® Test Plan. Chicago: Author.
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I. Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
II. 2023 NCLEX-RN® Test Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2
Beliefs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2
Classification of Cognitive Levels. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3
Test Plan Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3
� Client Needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3
� Integrated Processes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
� Clinical Judgment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
Distribution of Content . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
Overview of Content . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Safe and Effective Care Environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
� Management of Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
� Safety and Infection Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
Health Promotion and Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Psychosocial Integrity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Physiological Integrity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
� Basic Care and Comfort. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
� Pharmacological and Parenteral Therapies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
� Reduction of Risk Potential . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .13
� Physiological Adaptation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
III. Administration of the NCLEX-RN® . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Examination Length . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
The Passing Standard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Similar Items . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Reviewing Answers and Guessing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Scoring the NCLEX® . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
� Computerized Adaptive Testing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
� Pretest Items . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
� Passing and Failing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
� Scoring Items . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17
� Types of Items on the NCLEX-RN® . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
� NCLEX® Terminology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
� Examination Security and Confidentiality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
� Tutorial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Table of Contents
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Appendix A Sample Content . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Safe and Effective Care Environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
� Management of Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
� Safety and Infection Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Health Promotion and Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Psychosocial Integrity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
Physiological Integrity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
� Basic Care and Comfort . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
� Pharmacological and Parenteral Therapies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41
� Reduction of Risk Potential . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
� Physiological Adaptation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Appendix B Item Writing Tips . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Appendix C References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
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I. Background The test plan for the National Council Licensure Examination for Registered Nurses (NCLEX-RN®) was developed by the National Council of State Boards of Nursing, Inc. (NCSBN®). The purpose of this document is to provide detailed information about the content areas tested in the NCLEX-RN Examination.
This booklet contains:
� The 2023 NCLEX-RN® Test Plan;
� Information on testing requirements and sample examination questions (items);
� Item writing tips; and
� References.
About the NCLEX-RN® Test Plan The test plan is reviewed and approved by the NCLEX® Examination Committee (NEC) every three years. Multiple resources are used, including the recent practice analysis of registered nurses (RNs) and expert opinions of the NEC, NCSBN staff and boards of nursing/regulatory bodies, to ensure that the test plan is consistent with nurse practice acts. Following the endorsement of proposed revisions by the NEC, the test plan document is presented for approval to the Delegate Assembly, which is the decision-making body of NCSBN.
The test plan serves a variety of purposes. It is used to guide candidates preparing for the examination, to direct item writers in the development of items and to facilitate the classification of examination items. This document offers a comprehensive listing of content for each Client Needs category and subcategory outlined in the test plan. Sample items are provided at the end of each category that are specific to the Client Needs category in that section. There are item writing tips that provide nurse educators with guidelines on writing well-designed test items.
For up-to-date information on the NCLEX-RN Examination, visit the NCSBN website at NCLEX.com.
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II. 2023 NCLEX-RN® Test Plan
Test Plan for the National Council Licensure Examination for Registered Nurses (NCLEX-RN®)
Introduction Entry into the practice of nursing is regulated by the licensing authorities within each of the National Council of State Boards of Nursing (NCSBN®) member board jurisdictions (state, commonwealth, province and territorial boards of nursing). To ensure public protection, each jurisdiction requires candidates for licensure to meet set requirements that include passing an examination that measures the competencies needed to perform safely and effectively as a newly licensed, entry-level registered nurse (RN). NCSBN develops a licensure examination, the National Council Licensure Examination for Registered Nurses (NCLEX-RN®), which is used by member board jurisdictions and most Canadian nursing regulatory bodies, to assist in making licensure decisions.
Several steps occur in the development of the NCLEX-RN Test Plan. The first step is conducting a practice analysis that is used to collect data on the current practice of the entry-level nurse (Report of Findings from the 2021 RN Practice Analysis: Linking the NCLEX-RN® Examination to Practice [NCSBN®, 2022]). Twenty- four thousand newly licensed RNs are asked about the frequency, importance and clinical judgment relevancy of performing nursing care activities. Nursing care activities are then analyzed in relation to the frequency of performance, impact on maintaining client safety and client care settings where the activities are performed. This analysis guides the development of a framework for entry-level nursing practice that incorporates specific client needs as well as processes fundamental to the practice of nursing. Clinical judgment is one of the fundamental processes found to possess a high level of relevance and importance in the delivery of safe, effective nursing at the entry level.
Entry-level nurses are required to make increasingly complex decisions while delivering client care. These increasingly complex decisions often require the use of clinical judgment to support client safety. It is essential to note that clinical judgment applied in this dynamic supports the entry-level nurse to make effective decisions inside the nursing scope of practice, which provides a foundation for client safety. NCSBN has conducted several years of research and study to understand and isolate the individual factors that contribute to the process of nursing clinical judgment. These isolated factors are represented in the NCLEX-RN Test Plan and subsequently delivered as examination items. A more detailed description of clinical judgment can be found in the Integrated Processes section.
The second step is the development of the NCLEX-RN Test Plan, which guides the selection of content and behaviors to be tested. The NCLEX-RN Test Plan provides a concise summary of the content and scope of the licensing examination. It serves as a guide for examination development as well as candidate preparation. The NCLEX® assesses the knowledge, skills, abilities and clinical judgment that are essential for the entry- level nurse to use in order to meet the needs of clients requiring the promotion, maintenance or restoration of health. The following sections describe beliefs about people and nursing that are integral to the examination, cognitive abilities that will be tested in the examination and specific components of the NCLEX-RN Test Plan.
Beliefs Beliefs about people and nursing underlie the NCLEX-RN Test Plan. People are finite beings with varying capacities to function in society. They are unique individuals who have defined systems of daily living reflecting their values, motives and lifestyles. People have the right to make decisions regarding their health care needs and to participate in meeting those needs. The profession of nursing makes a unique contribution
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in helping clients (individual, family or group) achieve an optimal level of health in a variety of settings. For the purposes of the NCLEX, a client is defined as the individual, family, or group, which includes significant others and population.
Nursing is both an art and a science, founded on a professional body of knowledge that integrates concepts from the liberal arts and the biological, physical, psychological and social sciences. It is a learned profession based on knowledge of the human condition across the life span and the relationships of an individual with others and within the environment. Nursing is a dynamic, continuously evolving discipline that employs critical thinking and clinical judgment to integrate increasingly complex knowledge, skills, technologies and client care activities into evidence-based nursing practice. The goal of nursing for client care is preventing illness and potential complications; protecting, promoting, restoring and facilitating comfort; health; and dignity in dying.
The RN provides a unique, comprehensive assessment of the health status of the client, applying principles of ethics, client safety, health promotion and the nursing process. The RN then develops and implements an explicit plan of care considering unique cultural and spiritual client preferences, the applicable standard of care and legal considerations. The RN assists clients to promote health, cope with health problems, adapt to and/or recover from the effects of disease or injury, and support the right to a dignified death. The RN is accountable for abiding by all applicable member board jurisdiction statutes related to nursing practice.
Classification of Cognitive Levels Bloom’s taxonomy for the cognitive domain is used as a basis for writing and coding items for the examination (Bloom, et al., 1956; Anderson & Krathwohl, 2001). Since the practice of nursing requires application of knowledge, skills, abilities and clinical judgment, the majority of items are written at the application or higher levels of cognitive ability, which require more complex thought processing.
Test Plan Structure The framework of Client Needs was selected for the examination because it provides a universal structure for defining nursing actions and competencies and focuses on clients in all settings.
Client Needs
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.
Safe and Effective Care Environment
� Management of Care
� Safety and Infection Control
Health Promotion and Maintenance
Psychosocial Integrity
Physiological Integrity
� Basic Care and Comfort
� Pharmacological and Parenteral Therapies
� Reduction of Risk Potential
� Physiological Adaptation
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Integrated Processes
The following processes are fundamental to the practice of nursing and are integrated throughout the Client Needs categories and subcategories.
� 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.
� Clinical judgment – the observed outcome of critical thinking and decision-making. It is an iterative process with multiple steps that uses nursing knowledge to observe and assess presenting situations, identify a prioritized client concern and generate the best possible evidence-based solutions in order to deliver safe client care (detail description of the steps below).
� 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.
� Culture and spirituality – interaction of the nurse and the client (individual, family or group, including significant others and populations) that recognizes and considers the client-reported, self-identified, unique and individual preferences to client care, the applicable standard of care and legal considerations.
� Nursing process – a scientific, clinical reasoning approach to client care that includes assessment, analysis, planning, implementation and evaluation.
� Teaching/learning – facilitation of the acquisition of knowledge, skills and abilities promoting a change in behavior.
Clinical Judgment
The nurse engages in this iterative multistep process that uses nursing knowledge to observe and assess presenting situations, identify a prioritized client concern and generate the best possible evidence-based solutions in order to deliver safe client care. Clinical judgment content may be represented as a case study or as an individual stand-alone item. A case study contains six items that are associated with the same client presentation, share unfolding client information and address the following steps in clinical judgment.
� Recognize cues – identify relevant and important information from different sources (e.g., medical history, vital signs).
� Analyze cues – organize and connect the recognized cues to the client’s clinical presentation.
� Prioritize hypotheses – evaluate and prioritize hypotheses (urgency, likelihood, risk, difficulty, time constraints, etc.).
� Generate solutions – identify expected outcomes and use hypotheses to define a set of interventions for the expected outcomes.
� Take action – implement the solution(s) that address the highest priority.
� Evaluate outcomes – compare observed outcomes to expected outcomes.
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Distribution of Content The percentage of test questions assigned to each Client Needs category and subcategory of the NCLEX- RN Test Plan is based on the results of the Report of Findings from the 2021 RN Practice Analysis: Linking the NCLEX-RN® Examination to Practice (NCSBN, 2022) and expert judgment provided by members of the NCLEX Examination Committee (NEC). In addition to the Client Needs categories and subcategories listed below, clinical judgment processes are explicitly measured by 18 case study items (i.e., three item sets) and approximately 10% stand-alone items, which will be selected depending on exam length.
Client Needs Percentage of Items from Each
Category/Subcategory
Safe and Effective Care Environment
� Management of Care
� Safety and Infection Control
15–21%
10–16%
Health Promotion and Maintenance 6–12%
Psychosocial Integrity 6–12%
Physiological Integrity
� Basic Care and Comfort
� Pharmacological and Parenteral Therapies
� Reduction of Risk Potential
� Physiological Adaptation
6