Consider these tips to figure out why and help you pass next time

Why didn’t you pass the NCLEX? You’ve worked hard and passed all of your nursing classes, with descent and even glowing grades and then comes the board exam for licensing (NCLEX) and BAM you fail! Now what do you do? All your dreams and plans are on hold. You must tell your employer, friends and family and you don’t even know what happened. And what are you going to do next?

First you need to accept that you’re angry, hurt, and disappointed. Go ahead and cry, no really sob and then perhaps throw something …. Something soft. Don’t punch a wall! You’re likely to break something or harm yourself at least a little. Yell, scream, throw a regular two-year-old tantrum. OK now what?

Time to get real

Take a few deep breaths, wash your face and blow your nose. Get a drink of water, sit down and get comfortable. It’s just you – one on one. Resolve to be honest with yourself and figure out why you didn’t pass the NCLEX.

Think back. How many questions did you answer? Often if it shuts off quickly you may have failed, but that’s not always the case. Sometimes that means you passed. You could have answered all of the questions and either failed or passed. Or you could have passed with answering the minimum number of questions or answering all or most of them. It’s all in the algorithm.

Computerized Adaptive Testing

The NCLEX is a computerized adaptive test (CAT) that adapts to the student’s ability level. It’s not a typical multiple-choice test. It’s unique to the test taker. What does that mean? It adapts to your test taking ability. It utilizes a mathematical algorithm to determine your knowledge base and how you use critical thinking skills to figure out the problem and come up with the very best answer based on the facts. More than one or even all of the answers will be correct, but only one is the BEST answer.

You must use your critical thinking skills to prioritize the right answers and pick out the best one. An adaptive test starts off with relatively easy questions and will keep asking easier questions until you get one right. When you answer correctly, it will move to a more difficult question. This could seem like they’re asking the same thing in a slightly different way or something similar.

Then if you get a harder question wrong, you’ll get an easier one until you answer one correctly again and build back up with more difficult questions. If you never get out of the easy rounds, the test pool will run out of questions to keep asking and it will shut off.

If you answer the easy questions correctly then jump to the harder questions, the test will continue to adapt and ask even more difficult questions. As you keep answering the more difficult questions correctly, the test will reach the conclusion that you’re qualified to be a nurse and the test will shut off. The test taker will fail the exam.

Most nursing schools utilize this type of testing for a least a portion of their courses to help prepare nurses to pass the NCLEX. Pre enrollment tests such as the TEAS test utilize computer adaptive testing.

Break Down the Problem Areas

You will need to be bluntly honest with yourself to be able to figure this out. Think long and hard about what you didn’t know and struggled with. Dig deep and be truthful. Did you wrestle with a lot of answers and possibly picked the second-best answer? Did you second-guess yourself? Think about the subject matters. What caused you the most problem? Did you get stuck on the math? Were the drug-related questions too difficult? Did you struggle with disease specific questions? Do you remember any specific questions you know you didn’t know the answer to? Try to look up the topics and see what you may have missed.
Next, think about what was easy. What questions or subjects were you certain you got right? Think about those questions and verify what you’re sure was correct.
In verifying and reviewing the information does anything stand out and perhaps surprise you? Did you get something correct that you thought was wrong? Or were you mistaken about the things you felt confident in?
Write these down. Make flash cards. Write lists. Capture some talking points to help you remember. Follow your instinct on how you learn best and then try another option too just to reinforce the learning.

Consider Other Factors

Were there other circumstances that may have affected your ability to do your best? Did you have car trouble? Did you get lost? Did you oversleep? Did you get some breakfast? Did you sleep poorly? Did you feel poorly?  We’re not looking for excuses, just being honest and setting parameters to avoid if possible next time.
Do you have a problem with reading into questions? It’s imperative that you read the question completely and understand what’s being asked, but not read information into a situation that isn’t there. Do not make any assumptions. Stick to the information you are given and work within your scope of practice.
What are your strengths? What are your weaknesses? What clinical rotations made the most sense or did you like the best? Which ones did you like the least or struggle with? Did this correlate with what you did best and worst in on the exam? Any surprises?

Take Time Off

After you’ve written down as much as you remember, put it away. Take 3 days off and don’t think about the NCLEX or nursing, or what you need to do now. Relax, do something fun, and totally clear your mind. Give yourself a break and just let it all go for 3 days. Get some exercise to burn off pent up anger and energy. Sleep well. Eat well. Forgive yourself.
Come back refreshed and ready to begin. Make a plan. Schedule your next exam and be sure to avoid issues you had before to give yourself the best advantage. Plan your schedule to give you plenty of study time and time off just before the test date to rest and pamper yourself.

Start Again

Take a free NCLEX practice exam online; preferably one that gives you answers with rationale. Analyze your results. Remember there can be more than one right answer, but you need to choose the BEST answer. Look at the answers and ask yourself why the answer you chose is or isn’t the Best Answer. What raises the bar to make the Best Answer the correct choice? Does it even answer the question? This is a frequent mistake because it may restate some of the information in the question, but it may not really answer the question. Read carefully and consider all of the answers. Don’t second guess yourself. Often your first instinct is right. (See Easy NCLEX)
Relax, breathe, calm your mind
READ the question through. Stop and think about the information, the key words, and what it’s really asking for.
What evidence is provided in the question and what are you expected to know?
Which answers restate the evidence? They are likely going to be correct, but not always. Consider carefully. You will likely eliminate those that don’t restate the evidence. You will have to choose the answer that Best answers the question without adding in information that isn’t necessary to answer the question. Decide what makes this the Best answer?
Reading the questions “out loud” in your head can help you to see and hear the question better and help you to not read in information that isn’t there.
This also helps you read the question in slow motion and notice the giveaway clues that send up red flags such as “always and never” “except” “are or are not” etc. Write these down on scratch paper. Ingrain them in your mind and look for the answers that try to fool you and eliminate them.

Wait a Day and Retest

OK how did you do? Did you improve your score? Wait a day and re-take that exam.
Make flash cards for questions you got wrong. Make flash cards for things you got right but were unsure of. Make flash cards for a few things you got right and were certain of. Mix them up and study them. Go over the ones you got wrong and then the ones you got right. Don’t lose track of your successes.
Think about what you’re learning. What is working for you? Are you still struggling with finding the Best Answers? Are you reading into the questions? Are you just panicking and unable to focus? Work on those issues.
What are your strengths and weaknesses now?
Try another test and repeat all of the above.
Evaluate your progress. Is this helping you? Are you learning from your mistakes and even from your correct answers? Are you retaining information?

Reaching Out

Expand your study techniques beyond just you and the books. Ask your colleagues and friends what helped them. Perhaps a course, maybe a prep book, or study groups. Check on social media. There are many, many groups on Facebook who will offer advice and study suggestions.
Start a study group of your own. Use online resources for your group or find local students who need to study either for the first time or perhaps a second take as well. Each take a subject matter and specialize in it. Then tutor the others. Choose a subject that encompasses your strengths first and then do it again choosing a topic that you will be challenged to learn to be able to teach others.
In every task of life think about what you need to do, the steps involved and the rationale for why you do things that way. Is there a better way and why would it be better? It will help you stop and think critically instead of just doing things automatically.

Critical thinking skills are essential tools for nurses and the NCLEX tests your ability to apply what you know with critical thinking skills to a wide variety of scenarios. When the exam knows that you are able to meet the minimal established standard, you will pass the NCLEX!

Prepare for the Exam

Know where you are going for the test. Visit the site and familiarize yourself with directions, traffic complications and the parking situation. Get a good night’s sleep. Eat breakfast with some protein and carbs for short and long-term energy. Relax, calm your mind, and be confident. Remember to read everything carefully and look for the Best answer.

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