LIPPINCOTT Q&A REVIEW FOR
NCLEX-RN
14TH EDITION
• AUTHOR(S)DIANE BILLINGS;
DESIREE HENSEL
TEST BANK
NCLEX-RN — 20 MCQs (Billings & Hensel — Ch. 1: Introduction
& NCLEX-RN Preparation)
Q1
Reference: Ch. 1 — The NCLEX-RN® Licensing Examination —
The Test Plan / Practice Analysis
Stem: A newly graduated nursing student asks you how the
NCLEX-RN decides which content areas and cognitive levels
appear on the exam. Which explanation best describes the
,process used to create the NCLEX test plan?
A. The test plan is written by a single panel of nurse educators
who choose topics based on textbooks.
B. The test plan is based on a practice analysis that surveys
recently licensed nurses and employers about entry-level
practice.
C. The test plan is updated only when state nursing boards
request changes.
D. The test plan includes only content from popular NCLEX
review books.
Correct Answer: B
Rationale — Correct (B): The NCLEX test plan is grounded in a
formal practice analysis (job task analysis) that surveys recently
licensed nurses and employers to identify the knowledge, skills,
and abilities required for safe entry-level practice. This ensures
the exam reflects real, contemporary nursing practice and
supports content validity.
Rationale — Incorrect:
A. Wrong — multiple stakeholders, not a single panel, inform
the plan; relying on textbooks alone would omit practice data.
C. Wrong — state boards do not solely drive updates;
systematic practice analyses prompt revisions.
D. Wrong — review books are secondary resources and do not
determine the official test plan.
Teaching Point: The NCLEX test plan is based on a practice
analysis of entry-level nursing practice.
,Citation: Billings, D. M., & Hensel, D. (2024). Lippincott Q&A
Review for NCLEX-RN (14th ed.). Wolters Kluwer. Ch. 1.
Q2
Reference: Ch. 1 — The Test Plan — Client Needs & Integrated
Processes
Stem: A nursing instructor tells students that NCLEX questions
integrate client needs and process categories (e.g., safe care,
nursing process). Which test-taking strategy aligns best with this
structure when answering clinical items?
A. Focus only on disease pathophysiology to choose the answer.
B. Identify the client's need category and apply nursing process
and safety principles to select the best action.
C. Always choose the newest treatment option listed.
D. Eliminate any option that mentions patient education
because that is low priority.
Correct Answer: B
Rationale — Correct (B): NCLEX items are written to measure
clinical judgment across client needs and integrated processes
(e.g., nursing process, safety/risk reduction). Recognizing the
client need and applying assessment → diagnosis →
intervention → evaluation plus safety principles improves
answer selection.
Rationale — Incorrect:
A. Wrong — Pathophysiology is important but insufficient;
NCLEX tests application within nursing practice.
, C. Wrong — “Newest” treatment is not always safest or
appropriate for entry-level nursing decisions.
D. Wrong — Patient education is often a priority and part of
safe nursing care; eliminating it risks missing the correct option.
Teaching Point: Identify the client need and apply nursing
process + safety to the scenario.
Citation: Billings & Hensel (2024). Ch. 1.
Q3
Reference: Ch. 1 — Computer Adaptive Testing (CAT) — Exam
Administration
Stem: A candidate asks how the NCLEX CAT determines a pass
or fail. Which statement best explains CAT behavior during the
exam?
A. The computer gives questions in order of easiest to hardest
until time runs out.
B. The computer adapts item difficulty to the candidate’s
performance and stops when it can determine the candidate is
clearly above or below the passing standard.
C. The computer grades the exam only after the entire test is
completed and does not adapt during testing.
D. The computer uses a fixed set of 75 items for every test taker.
Correct Answer: B
Rationale — Correct (B): CAT selects items based on the
candidate’s responses — easier if many are incorrect, harder if
NCLEX-RN
14TH EDITION
• AUTHOR(S)DIANE BILLINGS;
DESIREE HENSEL
TEST BANK
NCLEX-RN — 20 MCQs (Billings & Hensel — Ch. 1: Introduction
& NCLEX-RN Preparation)
Q1
Reference: Ch. 1 — The NCLEX-RN® Licensing Examination —
The Test Plan / Practice Analysis
Stem: A newly graduated nursing student asks you how the
NCLEX-RN decides which content areas and cognitive levels
appear on the exam. Which explanation best describes the
,process used to create the NCLEX test plan?
A. The test plan is written by a single panel of nurse educators
who choose topics based on textbooks.
B. The test plan is based on a practice analysis that surveys
recently licensed nurses and employers about entry-level
practice.
C. The test plan is updated only when state nursing boards
request changes.
D. The test plan includes only content from popular NCLEX
review books.
Correct Answer: B
Rationale — Correct (B): The NCLEX test plan is grounded in a
formal practice analysis (job task analysis) that surveys recently
licensed nurses and employers to identify the knowledge, skills,
and abilities required for safe entry-level practice. This ensures
the exam reflects real, contemporary nursing practice and
supports content validity.
Rationale — Incorrect:
A. Wrong — multiple stakeholders, not a single panel, inform
the plan; relying on textbooks alone would omit practice data.
C. Wrong — state boards do not solely drive updates;
systematic practice analyses prompt revisions.
D. Wrong — review books are secondary resources and do not
determine the official test plan.
Teaching Point: The NCLEX test plan is based on a practice
analysis of entry-level nursing practice.
,Citation: Billings, D. M., & Hensel, D. (2024). Lippincott Q&A
Review for NCLEX-RN (14th ed.). Wolters Kluwer. Ch. 1.
Q2
Reference: Ch. 1 — The Test Plan — Client Needs & Integrated
Processes
Stem: A nursing instructor tells students that NCLEX questions
integrate client needs and process categories (e.g., safe care,
nursing process). Which test-taking strategy aligns best with this
structure when answering clinical items?
A. Focus only on disease pathophysiology to choose the answer.
B. Identify the client's need category and apply nursing process
and safety principles to select the best action.
C. Always choose the newest treatment option listed.
D. Eliminate any option that mentions patient education
because that is low priority.
Correct Answer: B
Rationale — Correct (B): NCLEX items are written to measure
clinical judgment across client needs and integrated processes
(e.g., nursing process, safety/risk reduction). Recognizing the
client need and applying assessment → diagnosis →
intervention → evaluation plus safety principles improves
answer selection.
Rationale — Incorrect:
A. Wrong — Pathophysiology is important but insufficient;
NCLEX tests application within nursing practice.
, C. Wrong — “Newest” treatment is not always safest or
appropriate for entry-level nursing decisions.
D. Wrong — Patient education is often a priority and part of
safe nursing care; eliminating it risks missing the correct option.
Teaching Point: Identify the client need and apply nursing
process + safety to the scenario.
Citation: Billings & Hensel (2024). Ch. 1.
Q3
Reference: Ch. 1 — Computer Adaptive Testing (CAT) — Exam
Administration
Stem: A candidate asks how the NCLEX CAT determines a pass
or fail. Which statement best explains CAT behavior during the
exam?
A. The computer gives questions in order of easiest to hardest
until time runs out.
B. The computer adapts item difficulty to the candidate’s
performance and stops when it can determine the candidate is
clearly above or below the passing standard.
C. The computer grades the exam only after the entire test is
completed and does not adapt during testing.
D. The computer uses a fixed set of 75 items for every test taker.
Correct Answer: B
Rationale — Correct (B): CAT selects items based on the
candidate’s responses — easier if many are incorrect, harder if
