The NCLEX-PN® Examination



The NCLEX-PN® Examination



Objectives


On completing this chapter, you will be able to do the following:


1. Explain the purpose of the National Council Licensing Examination for Practical Nurses (NCLEX-PN®) examination.


2. Research the requirements of your state board of nursing for eligibility to take the NCLEX-PN® examination.


3. Explain the significance of the Authorization to Test (ATT).


4. Describe how Computerized Adaptive Testing (CAT) determines whether you pass or fail the NCLEX-PN® examination.


5. Explain the process of endorsement.


6. Differentiate between a temporary work permit and licensure.


7. Discuss the proven way of preparing for the NCLEX-PN® examination.


8. Explain the legal implications of ignoring the NCLEX-PN® confidentiality agreement and sharing information about the NCLEX-PN® content with others.





image   Keep in Mind


Almost without exception, when student nurses are asked about their goal for the year, they respond by saying they want to pass the “boards,” meaning pass the National Council of State Boards of Nursing (NCSBN) practical/vocational licensure examination (NCLEX-PN®) to become a licensed practical or vocational nurse (LPN/LVN).




What is the NCLEX-PN® examination?


The NCLEX-PN® examination is the National Council Licensing Examination for Practical/Vocational Nursing graduates. It is designed to test minimum knowledge, skills, and abilities needed to safely and effectively practice nursing as a new entry-level LPN/LVN. The NCLEX-PN® examination results provide the basis for licenses granted to practical/vocational nurses by state boards of nursing.


The NCSBN developed a secure method of examination. Since April 1994, practical/vocational nursing graduates (candidates) have taken the NCLEX – PN® examination by computer. This method is called computerized adaptive testing (CAT). All candidates have different questions based on how they answer the previous question. Computer technology makes it possible to choose items from a large pool of questions classified by test category and difficulty to match the candidate’s ability and fulfill NCLEX-PN® requirements.


All candidates answer a minimum of 85 items and up to a maximum of 205 items in the 5- hour period of time allotted for the examination. Twenty-five of the items are pretest items (possible future test questions) and are not scored. The time allotted includes the confidentiality agreement, tutorial instruction, and scheduled and unscheduled breaks. All breaks are optional. All answers are scored as right or wrong; no partial credit is given. The computer continues with questions until it determines that the candidate passes or fails the examination. If the candidate runs out of time, and the candidate has not answered the minimum number of questions, the candidate fails. If the candidate has answered the minimum number of questions, the computer evaluates the last 60 items, and if the answers were consistently above the passing standard, the candidate passes.


Computerized adaptive testing administers items with difficulty levels so that each candidate will answer about half correctly. These items provide the most information. All candidates answer about 50% correctly because the computer presents them with questions to match their ability. The next item should not be too easy or too difficult. The computer goes down a “pathway” or “branch,” and no candidate has exactly the same test. Items that follow are based on the candidate’s previous answer. This is why you must answer every item on the computer screen as they show up. You will not be able to go back and answer a previous question. The computer calculates each answer before it can choose the next item.



How the NCLEX-PN® examination is kept up to date


The April 2011 NCLEX-PN® examination reflects the outcome of the 2009 LPN/LVN Practice Analysis: Linking the NCLEX-PN® Examination to Practice (NCSBN, 2009). Currently this survey is conducted every three years. Of the 12,000 surveys sent out, analyzable response rates were 17.7% for paper surveys and 7.0% for the web. The NCSBN (2011) explains the survey as follows:


Newly licensed practical/vocational nurses are asked the frequency and priority of performing 150 nursing activities. Nursing care activities were then analyzed in relation to the frequency of performance, impact on maintaining safety, and client care settings where the activities are performed.


The 2009 analysis indicated the following:



• 87.9% of participants were female.


• 59.7 were white non-Hispanic.


• 20% were African American.


• 7.7% were Latino or Hispanic.


• 4.3% were Asian.


• The average time of employment since licensure was 4.3 months.


• 56% reported working an average of 4.9% years as a nurse aide.


• Nurse participants worked in long-term care facilities (56.9%), community-based or ambulatory facilities (19.8%), and hospitals (16.8%).


• Almost half worked the day shift. An equal percentage worked evening and night shifts.


• Work of the newly graduated 2009 LPNs/LVNs consisted primarily of pharmacologic therapies:


• Safety and infection control


• Activities related to basic care and comfort


• Physiologic adaptation


• The least amount of time was spent on activities related to coordinated care.


• Nursing care was provided primarily to elderly and adult patients.


• Over half of these patients had a chronic stabilized illness.


• Almost half had behavioral/emotional problems.


• Approximately one third of the LPNs/LVNs worked with patients needing end-of-life care.


• Approximately 45.2% of the LPNs/LVNs had one or more administrative duties.


• The most frequent administrative activity was as charge nurse, primarily in the long-term care facilities. The next most frequent was as team leader.


• 61% had earned one or more certifications or completed additional course work.


• The most common certifications included basic life support, IV therapy, and phlebotomy.


• 39% had no additional course work or certification.


• 25.6% had enrolled in the RN program.


• Only minor changes were made in the 2011 Test Plan for currency and clarification.


The entire study, is available online at www.ncsbn.org or you can Google it by typing in “Report on Findings from the 2009 LPN/LVN Practice Analysis: Linking the NCLEX-PN® Examination to Practice.” Use the exact title. The practice analysis can be downloaded from the site.



Core content


Four phases (steps) of the nursing process (see Chapter 9) are integrated into all areas of the NCLEX-PN® examination. The four phases are the basis for nursing care plans you developed for each patient assigned to you, prior to beginning nursing care on the clinical unit. The four steps (phases) are:




Types of test questions


The NCLEX-PN® examination contains items (questions) in the cognitive level of knowledge, comprehension, application, and analysis. Most of the questions are at the application and analysis levels. These questions require prioritizing and decision making. The two main types of test questions are multiple choice and alternate item format.




Alternate Item Format


The NCLEX-PN® examination also includes alternate item questions, including the following:



• Fill-in-the-blank. Medicine and IV rate calculations, intake and output totals.


• Multiple responses. Select all responses that pertain to the question, with no partial credit given. For example: Which of the following drugs are antihypertensives?


• Prioritizing (ordered response). Options (nursing actions) are numbered as first, second, third, and so on, in order of priority, or the mouse is used to drag and drop options in the ordered priority. For example: When doing the Heimlich maneuver, which of the following actions would you do first, second, third, and so on?


• Figure or illustration (hot spot). Questions are asked about a chart or figure. Either an answer is chosen from a list or the mouse is used to point and click a “hot spot” as the answer. For example: Click on the hypochondriac area.


• Chart/exhibit questions. A question is included with a chart or exhibit requiring use of the chart/exhibit to answer the question. For example: Which lab result is normal?


An on-screen optional calculator is available for your use during the examination. Any format item, including standard multiple-choice items, might include charts, tables, or graphic images. A tutorial is provided on the computer screen regarding the operation of the computer and how to record answers. For general information about the NCLEX-PN® examination, email nclexinfo@ncsbn.org.



image   Try This


What Is an Alternate Item Question?


Write an example of an alternate item format using problem solving.



Test framework: client needs


The content of the NCLEX-PN® examination is divided into four Client Needs categories. Client Needs provide an overall structure for defining nursing actions and competencies for a variety of patients in many settings and are in agreement with state laws and statutes. Two of the four categories are further subdivided. The percentage of test items assigned to each category and limited examples of content are included. Additional examples of content are found in the NCLEX-PN® Examination Test Bulletin and the 2012 NCLEX-PN® Examination Candidate Bulletin, available at ncsbn.org; type “NCLEX-PN” in the search box. The categories and subcategories are as follows (examples, but not a complete listing):



1. Safe, Effective Care Environment



2. Health Promotion and Maintenance: 6% to 12%


    Examples: Aging process, ante/intra/postpartum and newborn care, data collection techniques, developmental stages and transitions, high-risk behaviors, lifestyle choices, self-care


3. Psychosocial Integrity: 6% to 12%


    Examples: Abuse or neglect, behavioral management, crisis intervention, chemical and other dependencies, end-of-life concepts, mental health concepts, stress management, therapeutic communication


4. Physiologic Integrity


Related posts:

  1. Critical Thinking: A Lifelong Journey
  2. Time Management: Making Time Work for You
  3. How Practical/Vocational Nursing Evolved: 1836 to the Present
  4. Assertiveness: Your Responsibility

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Mar 1, 2017 | Posted by in NURSING | Comments Off on The NCLEX-PN® Examination

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