3 Step Guide to Dissect NCLEX Questions Cleverly

Being a nursing student, you must have already heard that cracking NCLEX is tough. If you have adequately prepared and know what you’re doing during the exam, then passing the NCLEX exam should be a breeze. The matter of fact is that during those two and a half hours, you will be sitting in a tense situation as the entire atmosphere inside the exam hall is nerve-wracking. It gets even scarier if you have no idea how to tackle the question paper.

We have got something for you that might prove to be useful for you during the test. So, let’s get on with it!

Types of NCLEX Questions

The most efficient way to tackle an NCLEX-PN exam is knowing what kind of questions will be asked in the paper. NCLEX question papers follow a set methodology of writing items called Bloom’s Taxonomy for the Cognitive Domain. Bloom’s Taxonomy is nothing but a classification of the objectives behind learning and their arrangement on various levels of one’s brain processing powers and cognitive abilities. What makes Bloom’s Taxonomy so striking is the fact that every level depends on the mastery of the lower levels. Without being able to understand the lower levels, one cannot hope to master the higher ones.

Being a nurse means people will trust you with their lives. It will happen all too often that you will be summoned when a patient is at his absolute worst, or you will be the first one to encounter him/her upon arrival at the hospital. Thus, you will need to have the ability to assess a patient’s condition, symptoms in a matter of seconds and act accordingly as any delay, hesitation or oversight can be catastrophic. You will need to analyze and evaluate instantaneously, and it is a skill which you will need to learn. You will need to have sound knowledge and a lot of practice. That is why Bloom’s Taxonomy is used which tests the candidates well.

From bottom to top, each section of the above diagram states the increasing level of cognitive ability and each level depends on the lower level.

  1. Remember: The first section demands that you remember all that you have learned.
  2. Understand: The second section is understanding what you have remembered. When you are not just repeating the words you read, but also reciting or writing them because you know what those words mean, then you can move to the third step.
  3. Apply: Theory alone is never enough, especially in the profession of nurses. Only if you understand what you are doing can help you carry out a process efficiently.
  4. Analyze: Being a nurse, you will be required to see what other’s can’t. Your powers of observation will have to be astonishing. Also, you will need to have a logical road map ready to analyze a patient’s condition and gather related data.
  5. Evaluate: Once you have analyzed a patient, you have the data and thus are ready to form an opinion or a verdict about his/her condition.
  6. Create: This section doesn’t quite apply in the NCLEX question paper directly, but in Bloom’s Taxonomy, it means that when you understand everything, you can go on and create.

NCLEX questions are usually designed on the Apply or higher levels of cognitive ability since. As we mentioned earlier as well, you will need to make real-time decisions being a nurse on which a patient’s life will depend. It requires you to have a splendid thought process, command over your skills, and assured hands of an experienced person.

It is commonly believed that if you get a lot of Select All That Apply (SATA) items on the NCLEX question paper, then that means it is operating in the Evaluate section of Bloom’s Taxonomy, and it is the reason why nursing students are often asked to have critical thinking. But sadly, it happens all too often that instructors only recite the words critical thinking and don’t know how to instill it in their students.

Thus, most students walk in exam halls utterly oblivious to what they are about to face. They are levels below the required cognitive ability to crack the NCLEX exam, and that is the reason why so many students fail so many times. Therefore, as a student, you need to understand that it is your job always to ask why to every action in order to climb up the cognitive ladder and develop critical thinking.

Elements of an NCLEX Question

After taking a look at the types of questions that you can expect in your NCLEX question paper, it is time we move on to the items and start peeling them layer by layer. Most of you must have already known that NCLEX consists of multiple choice questions or MCQs, also known as objective type questions. These questions are called so because a bunch of options, usually four, are provided for each item. In some cases, there can be one or more correct answers to a question.

An NCLEX question is usually made up of various elements:

  1. Item: It is what we call the cluster of the entire item and all its answers
  2. Stem: It is the main question that is being asked in the test
  3. Options: This is the multiple choice aspect of these questions, i.e., the selection of possible answer/answers to the Stem. While they can be incredibly helpful at times, an examiner sometimes tries to put options as similar to each other as possible to make the task confusing for the applicants.
  4. Correct Answer: The right answer to the question.
  5. Distractors: These are all the wrong answers. As we mentioned earlier as well, the distractors will seem like plausible answers as the examiners try to give you options which are too close that distinguishing among them becomes difficult.

In the end, everything depends on the Stem, and you should always read each item carefully. To keep the spirit of dissection alive, let us take a more in-depth look at some characteristics of the Stem. The Stem can be a complete sentence or an incomplete one which would be completed with the answer. So, it becomes a veritable hybrid between an MCQ and a fill in the blank question.

There can be positive Stems, which ask questions regarding what is right, and there can be negative Stems as well which demand to select the false option. While positive Stems are easy to identify, negative ones are a little hard to recognize. So, you need to be extremely careful while you read the question. One of the most effective ways to identify a negative Stem is by looking for below words in the Stem:

  • except
  • not
  • never
  • further
  • least
  • avoid
  • contraindicated

The Nursing Process

It is absolutely imperative for every nurse to understand the Nursing Process by heart. It is one of the most basic and essential laws of nursing which is followed pretty much every time a nurse is with a patient. The Nursing Process is equally important from the NCLEX point of view as well. Let us have a closer look at it.

The Nursing Process is made of five alphabets – A, D, P, I, and E (ADPIE):

A: Assessment

D: Diagnosis

P: Plan

I: Implement

E: Evaluate

These alphabets lay out a proper plan which you need to follow while treating a patient. The first step is the assessment of his/her condition by collecting the required data. The second step is diagnosing the problem. Once you have done that, it is time to make a plan and implement it. Finally, you need to make sure that the idea had the desired effect on the patient or not.

ADPIE is a road map for investigating a patient. Critical thinking requires an accurate assessment of a patient’s condition, and that is why the Nursing Process holds vital importance. It tells you the steps you need to follow to give the best care to a patient.


As we mentioned earlier too, the theory part alone is not enough for a nurse. Now that you know how to tackle an NCLEX question, it is time you start practicing. There are a lot of resources available online that will help you get ready for your NCLEX-PN examination, such as mock tests and podcasts. So, study hard and develop critical thinking by continually challenging yourself with tough questions. Do your best and you will be able to pass the NCLEX exam without a hiccup.