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Rookie Wit & Wisdom

Although each state educates and regulates its nurses individually, all nurses take the same licensing exam. For practical and vocational nurses, the exam is called the National Council Licensure Examination for Practical Nurses, or NCLEX PN. Once the nurse has graduated from an accredited program, she is eligible to take the computerized examination to become a licensed practical or vocational nurse -- an LPN or LVN. A number of NCLEX PN review tutorials exist in both online and written form.

How the NCLEX PN is Created

One of the best resources for the NCLEX PN review questions is available from the National Council of State Boards of Nursing, which creates, reviews and revises the exam. Every three years, the NCSBN performs a practice review to analyze the practice of practical nursing and determine what has changed. The NCSBN surveys recent LPN graduates about how often they perform any of 150 nursing care activities and the priority of each activity as related to nursing practice. The responses are analyzed to determine where the activities are performed and what their relevance is to patient safety. New findings are incorporated into the exam and material that is outdated or no longer relevant to current practice is discarded. Since each state has different regulations related to scope of practice -- the activities LPNs are legally permitted to perform -- the NCSBN takes those variations into account in revising the exam.

NCLEX Exam Structure

The NCLEX PN is structured according to four major categories:
• Safe and effective care environment.
• Health promotion and maintenance.
• Psychosocial integrity.
• Physiological integrity.

The first and last categories are divided into subcategories:
• Safe and effective care environment is subdivided into coordinated care and safety and infection control.
• Physiological integrity is subdivided into basic care and comfort, pharmacological therapies, reduction of risk potential and physiological adaptation.

In the simplest terms, these categories are designed to test the candidate’s knowledge of basic safety, prevention of harm, maintaining or improving the patient’s health, medication management and keeping the patient comfortable both physically and emotionally.

Woven throughout the test are four processes related to practical nursing:
• Clinical problem-solving.
• Caring.
• Communication and documentation.
• Teaching and learning.

Each section or subsection of the test contains approximately 7 to 19 percent of the questions to ensure that all topics are thoroughly covered.

Study Resources

You will find many resources to study for the NCLEX PN. Most are online, as an online system allows for regular updating as the test questions change. Study guides, flashcards and examination reviews are all available, usually for less than $40. The NCSBN tutorial is free. Some examples of NCLEX PN study resources include the Saunders Q & A Review for the NCLEX-PN® Examination, the Saunders Comprehensive Review for the NCLEX-PN® Examination, the website and the NCLEX-PN Flashcard Study System. Many include examples of the NCLEX PN questions.

Taking the NCLEX Exam

You must take the NCLEX PN as an online test, in a designated exam center such
as college classroom or library. There is a $200 fee for the exam, which must be paid prior to starting the examination, and you must schedule a specific time to take the examination. The exam is administered through computerized adaptive testing, which allows the exam to be adjusted to match the candidate’s ability. All test items are stored electronically in a large pool. As you answer each question, the computer calculates your ability based on your previous answers, and tailors the next question based on your ability. You must answer a minimum of 85 items to pass the test, although you may answer as many as 205. The computer will shut off once you have successfully answered enough questions or when you reach the time limit. You have five hours to complete the test, which includes time to complete the tutorial, answer sample questions and take breaks. The test may include multiple choice questions, fill-in-the-blank questions, calculations, charts, tables, sound or video presentations.

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