Preparing for the Licensure Examination

chapter 1


Preparing for the Licensure Examination


imagehttp://evolve.elsevier.com/Mosby/comprehensivePN


The practice of nursing is regulated by law in each state; the District of Columbia; and the U.S. possessions of Guam, Puerto Rico, the Virgin Islands, American Samoa, and the Northern Mariana Islands for the express purpose of protecting the public. The state board of nursing in each of these jurisdictions is charged with upholding the regulation of such law. To do so, each state board of nursing requires that qualified individuals take a licensing examination developed and prepared by the National Council of State Boards of Nursing (NCSBN or The National Council). The examination, known as the National Council Licensure Examination for Practical Nurses (the NCLEX-PN® examination), is available in the previously named jurisdictions and only in English. Puerto Rico has developed its own licensing examination that is available in Spanish; however, the content covered in the examination closely parallels that of the NCLEX-PN examination. This text serves as a valuable review tool regardless of the licensure examination taken by an individual.


First and foremost, all candidates must register to take the NCLEX-PN examination. Because the registration process may differ from state to state, you should contact the State Board of Nursing in the state in which you want to become licensed for detailed information on the process. There are several ways you can register (online, by telephone, or by mail). It is critical that you follow the registration instructions precisely because improperly completed forms or those not accompanied by the appropriate fees will be returned, thus delaying the overall registration process.


Once eligibility to test has been determined, you will receive an Authorization to Test (ATT) form. You can now proceed to schedule an appointment to take the NCLEX-PN examination at a Pearson VUE Professional Center (www.vue.com/nclex). The ATT form is an essential document; it contains your test authorization number, your candidate identification number, and an expiration date. It is important that you note the expiration date on the form because you must take the NCLEX-PN examination before the date listed on the form. Do not misplace this document; you will need it to be admitted to the examination.


If you must cancel or reschedule the date for your examination, you can do so up to 24 hours before your scheduled testing date. Although it is possible to cancel or reschedule, you will forfeit fees already paid, and your ATT form will become invalid.


A special section later in this chapter details issues that foreign-educated nurses face when preparing for licensure in the United States.


The NCLEX-PN examination covers all areas of the practical/vocational nursing curriculum and has been designed to test “the knowledge, skills, and abilities that are essential for the entry-level practical/vocational nurse to meet the needs of patients who require the promotion, maintenance, or restoration of health” (NCSBN, 2011). Periodic revision of the examination test plan can be expected because of the continually changing face of nursing. Nevertheless, such changes do not compromise use of this text when preparing for the licensing examination. This chapter is essential as you begin your preparation because it reviews any changes in the examination test plan and provides details and examples of the new testing formats that will be part of the examination.



WHY REVIEW?


The practical/vocational nurse uses “specialized knowledge and skills which meet the health needs of people in a variety of settings under the direction of qualified health professionals” (National Federation of Licensed Practical Nurses [NFLPN], 2003). “Competency implies knowledge, understanding and skills that transcend specific tasks and is guided by a commitment to ethical/legal principles” (National Association for Practical Nurse Education and Service [NAPNES], 2007). The licensure examination assesses entry-level competencies using a variety of testing formats that analyze an individual’s use of the clinical problem-solving process (the nursing process) to gather relevant health care data, assist in identifying patient needs at various periods during an individual’s life span from birth through the elder years, and contribute to team (interdisciplinary) efforts in a variety of settings.


The purpose of this text is threefold: (1) to assist you in identifying areas of specific strengths and weaknesses in your nursing knowledge and skills, (2) to increase your understanding of nursing knowledge through additional study, and (3) to increase your familiarity with and ability to respond to written test questions and corresponding clinical situations similar to those presented in the NCLEX-PN examination.


The National Council’s test plan for the NCLEX-PN examination consists of one essential content dimension or framework: client need. This framework provides a structure that is universal in defining the actions and competencies necessary to provide safe and effective nursing care to patients in various health care settings. Therefore the dimension of client need is critical to ensure the overall intent of the examination: to protect the public through safe practitioners. A more detailed description of the 2011 NCLEX-PN Test Plan and the distribution of content for the examination are provided in Box 1-1.



Box 1-1


Test Plan for the National Council of State Boards of Nursing Licensure Examination for Practical/Vocational Nurses


Major Client Need Categories, Related Concepts, and Distribution of Content



image


Modified from National Council of State Boards of Nursing: The NCLEX-PN® examination test plan for the national council licensure examination for practical nurses, Chicago, April 2011. Detailed information about the NCLEX-PN Test Plan and the NCLEX Examination Candidate Bulletin is available from the National Council of State Boards of Nursing on their website: www.ncsbn.org.


The 2011 revision encompassed minor changes to the four major client needs categories, and two of the four categories are further divided into subcategories as was done in the 2003 revision; however, two of the four categories became separate entities in 2005. The 2011 changes included revision of the percentage of test items in all categories and subcategories, except for the category of Health Promotion and Maintenance, which remains at 7% to 13%. Possible changes in the 2014 revision of the NCLEX-PN Test Plan may include slight increases or decreases in the percentage of items from each category and subcategory, as well as minor changes in related content for each category and subcategory. These anticipated changes are based on a review of the changes that have occurred in the 2013 NCLEX-RN Test Plan. Please note that although the test plan may undergo change every 3 years to remain current and reflect updated entry-level practice, all content and related concepts will remain critical components of the NCLEX-PN examination.



EFFECTIVE STUDY AND USE OF THIS TEXT


The key to effective study and use of this text can be determined only by you. This review is presented in a manner that is easily adaptable to various forms of study habits and familiarizes you with timed tests or examinations.


Each chapter outlines a specific content area within the practical/vocational nurse curriculum, followed by a set of questions relative to that particular content area. The answers and the rationales for both the correct and incorrect responses are found at the end of the chapter. Rationales for all four answer choices are provided for each question. The rationale for the correct answer is listed first, followed by rationales for the incorrect responses.


The questions in this text have been classified to reflect those of the NCLEX-PN examination—cognitive level, nursing process (integrated process), client need, and level of difficulty. These classifications follow the question number in the Answers and Rationales portion of the chapter:



1. First classification or word—the cognitive level of the question



2. Second classification or word—phase of the nursing process (integrated process)



3. Third classification or word(s)—one of the four client need categories



4. Letters in parentheses—the difficulty of the question



You may want to start your study process with the chapter questions first to determine areas in which you need more study time and then return to review the outline of that particular chapter in its entirety. Once you have completed review of the chapter, return to the questions and review a second time. Concentrate study efforts on those areas in which you scored low during your first assessment of the chapter questions. Should you need more in-depth study, you may refer to texts from the Bibliography found at the end of each chapter, your own nursing texts, or current nursing journals.


Once you have completed the content review and corresponding chapter questions, you are ready to take the comprehensive examination found in the text, which consists of two parts, each containing 125 questions and taking approximately 2 hours to complete. An additional comprehensive examination, also consisting of two parts, each containing 125 questions and taking approximately 2 hours to complete, is found on the accompanying CD. Time yourself or have someone else monitor your time. Although you are given 5 hours to complete the NCLEX-PN examination, practicing time management skills during your review sessions promotes self-confidence and should decrease extreme anxiety during the actual examination.


In April 1994 the National Council began administering the NCLEX-PN examination by means of computerized adaptive testing (CAT), a definite change from the traditional paper-and-pencil method of testing. CAT allows candidates to take the examination at their own pace. No set minimum amount of time has been established for the examination; however, a maximum time period of 5 hours is available to all candidates. Each candidate’s examination is essentially unique to him or her because it is created interactively as the candidate progresses through the examination.


To effectively use this text in preparation for CAT, we suggest that, using a pencil or pen with erasable ink, you darken your answer choice on the chapter review questions and the comprehensive examination questions. Marking your answers in this manner allows you to concentrate on answering the questions much as you would during the actual examination.


Even though time may no longer be a major concern, becoming more proficient in time management will be to your advantage during the actual examination. The review process, which includes proper use of this text, increases not only your nursing knowledge, but also your self-confidence in that knowledge and in your test-taking abilities.


The Evolve website (http://evolve.elsevier.com/Mosby/comprehensivePN/) offers the student three modes from which to choose: Study, Exam, and Comprehensive Examination. In the study and exam modes, categorized questions help the student identify areas of strength and weakness by classification. To achieve this, the questions are divided into the following 9 categories:



The Comprehensive Examination mode consists of two 250-question comprehensive examinations; students can choose to take Comprehensive Examination 1, Comprehensive Examination 2, or a random selection with questions from each of the comprehensive examinations.


Remember that intelligence plays a vital role in your ability to learn. However, being smart involves more than just intelligence. Being practical and applying common sense are also part of the learning experience.


Regardless of how you choose to study, you may find the tips to improve study habits in Box 1-2 helpful as you develop your study plan.



Box 1-2   Tips to Improve Study Habits




1. Establish your study priorities and the goals by which to achieve these priorities. Write them out and review the goals during each of your study periods to ensure focused preparation efforts.


2. Enhance your organizational skills by developing a checklist and creating ways to improve your ability to retain information, such as using index cards with essential data, which are easy to carry and review whenever you have a spare moment.


3. Enhance your time-management abilities by designing a study program that best suits your needs and current daily routines by considering issues such as the following:



4. Prepare for study by reflecting on the following:



A word of warning: do not expect to achieve the maximum benefits of this review text by cramming a few days before the examination. It doesn’t work! Instead, organize planned study sessions in an environment that you find relaxing, free of stress, and supportive of the learning process.



ITEM FORMATS


By now you more than likely have been exposed to a variety of testing in both the objective and subjective formats. The licensing examination primarily contains the objective type, better known as the multiple-choice form of testing. The multiple-choice question by now is one with which you are most familiar. Each multiple-choice question contains a stem (the main intent of the question) followed by four plausible answers or alternatives that either complete a statement or answer the question. Only one of the alternatives is the best answer; the remaining three alternatives are known as distracters, so named because they are written in such a way that they could be the correct answer and thus distract you to a certain degree.


However, since April 2003 alternate and more innovative item formats have been added to the examination. These new formats include multiple response, fill in the blank (i.e., calculation), drag and drop/ordered response, hot spot (i.e., identifying an area on a picture or graphic), chart/exhibit (i.e., reading information in a chart or exhibit to solve a problem), graphic (i.e., multiple-choice question with graphic answer options instead of text), and sound (audio) or video. All item formats, including the standard multiple-choice format, could have charts, tables, or graphic images. Do not panic! At some point in your nursing program, you will have been exposed to all of the previously named formats. Samples of these formats appear in Boxes 1-3 to 1-10.



TEST-TAKING SKILLS


Whether these testing formats are familiar to you or not, the following common sense pointers will help you to avoid some common test-taking errors:



1. Listen to the examiner and follow directions carefully. All candidates are given a short training session, which includes a keyboard tutorial complete with a practice session. Prior computer experience is not necessary. Should you have any questions specific to directions given, ask the examiner for clarification.


2. Answer the question that is asked. Read the situation and the question carefully, looking for key words or phrases. Do not read anything into the question or apply what you did in a similar situation during one of your clinical experiences. Think of each question as being an ideal, yet realistic, situation.


3. Have confidence in your initial response to an item because it more than likely is the correct answer. If you are unable to answer a multiple-choice question immediately, eliminate the alternatives that you know are incorrect and proceed from that point. The same goes for a multiple-response question that requires you to choose two or more of the given alternatives. If a fill-in-the-blank question poses a problem, read the situation and essential information carefully and then formulate your response. Although a time factor is not involved, do not spend an excessive amount of time on any one question. One minute—60 or possibly 70 seconds—is the recommended time allotted to any one question, but not all questions will take even a full minute; some may take only 20 to 30 seconds to read and answer.


    It is important to note that, with CAT, skipping questions or going back to review and/or change a response is not possible. You must answer the question on the screen because you will not be able to continue with the examination until you have done so.


4. Avoid taking a wild guess at an answer. However, should you feel insecure about a question, eliminate the alternatives that you believe are definitely incorrect, and reread the information given to make sure you understand the intent of the question. This approach increases your chances of randomly selecting the correct answer or getting a clearer understanding of what is being asked. Although there is no penalty for guessing on the NCLEX-PN examination, the subsequent question will be based, to an extent, on the response you give to the question at hand; that is, if you answer a question incorrectly, the computer will adapt the next question accordingly based on your knowledge and skill performance on the examination up to that point.


5. Candidates receive information before the examination and a tutorial the day of the examination. Additional information can be obtained by logging onto the Pearson VUE website, www.vue.com/nclex, or the website for the NCSBN, www.ncsbn.org.


6. Above all, begin with a positive attitude about yourself, your nursing knowledge, and your test-taking abilities. A positive attitude is achieved through self-confidence gained by effective study. This means (a) answering questions (assessment), (b) organizing study time (planning), (c) reading and further study (implementation), and (d) answering questions (evaluation).

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Mar 17, 2017 | Posted by in NURSING | Comments Off on Preparing for the Licensure Examination

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