LIPPINCOTT Q&A REVIEW FOR
NCLEX-RN
14TH EDITION
• AUTHOR(S)DIANE BILLINGS;
DESIREE HENSEL
TEST BANK
1
Reference: Ch. 1 — The NCLEX-RN® Licensing Examination —
Computer Adaptive Testing (CAT) and Passing Standard
Stem: A nursing graduate calls the licensing board asking why
the NCLEX stopped after 85 questions and showed a pass result.
She is anxious because she expected a fixed-length test. As the
RN educator, what is the best explanation to reassure her?
A. “The test uses a fixed passing score and stops when you
reach that score with confidence.”
B. “The exam is computer adaptive and ends when your ability
,is clearly above or below the passing standard.”
C. “Pearson stops the test early only when there is a technical
problem; otherwise it always goes to the maximum items.”
D. “The testing algorithm compares you to other candidates
and stops after average performance is reached.”
Correct Answer: B
Rationales:
Correct (B): The NCLEX uses computer adaptive testing (CAT);
the test algorithm continues selecting items until it can
determine with statistical confidence that the candidate’s ability
is above (pass) or below (fail) the passing standard. This
explains an early stop and pass result.
Incorrect (A): Misstates mechanism—there is no single fixed
raw score; the CAT uses an ability estimate relative to a
standard, not a fixed numeric cutoff.
Incorrect (C): Early stopping is not limited to technical
problems; it commonly occurs when the candidate’s ability is
clearly established.
Incorrect (D): The CAT does not stop based on “average”
performance compared to other candidates; it compares the
candidate’s ability to the established passing standard.
Teaching point: CAT stops when it can statistically confirm
ability relative to the passing standard.
Citation: Billings, D. M., & Hensel, D. (2024). Lippincott Q&A
Review for NCLEX-RN (14th ed.). Wolters Kluwer. Ch. 1.
,2
Reference: Ch. 1 — The NCLEX-RN® Licensing Examination —
Test Plan & Practice Analysis
Stem: A nurse educator developing an NCLEX review course
wants to align questions with the current test plan. Which
approach best ensures alignment with the NCLEX test plan and
practice analysis?
A. Include more pharmacology recall items because drug
knowledge is most important.
B. Base question topics and cognitive level on the test plan’s
client needs and practice analysis outcomes.
C. Use only factual content from textbooks without scenario-
based application.
D. Focus exclusively on procedural skills checklists since the
exam tests performance.
Correct Answer: B
Rationales:
Correct (B): The NCLEX test plan is founded on practice analysis
and organizes content by client needs, cognitive levels, and
clinical judgment requirements—so aligning questions to those
domains ensures validity.
Incorrect (A): Overemphasizing one content area
(pharmacology) risks poor alignment with the distributed
content of the test plan.
Incorrect (C): Pure recall questions do not reflect NCLEX
emphasis on clinical judgment and scenario-based application.
, Incorrect (D): While skills are important, the NCLEX tests clinical
judgment via scenarios, not procedural checklists alone.
Teaching point: Build items to the test plan’s client-needs
categories and cognitive objectives.
Citation: Billings & Hensel (2024). Ch. 1.
3
Reference: Ch. 1 — The NCLEX-RN® Licensing Examination —
Computer Use and Screen Design
Stem: A candidate arrives at the test center concerned about
using a computer for the first time. Which action by the testing
center staff best supports candidate readiness before the exam
begins?
A. Require the candidate to complete a full practice CAT exam
of 100 items.
B. Provide a short tutorial on computer functions and on-screen
tools before testing.
C. Offer printed copies of all on-screen questions for review.
D. Reduce the testing time to accommodate unfamiliarity.
Correct Answer: B
Rationales:
Correct (B): Test centers provide a tutorial or orientation to
computer functions and on-screen tools so candidates can
navigate the exam interface; this supports test security and fair
access.
NCLEX-RN
14TH EDITION
• AUTHOR(S)DIANE BILLINGS;
DESIREE HENSEL
TEST BANK
1
Reference: Ch. 1 — The NCLEX-RN® Licensing Examination —
Computer Adaptive Testing (CAT) and Passing Standard
Stem: A nursing graduate calls the licensing board asking why
the NCLEX stopped after 85 questions and showed a pass result.
She is anxious because she expected a fixed-length test. As the
RN educator, what is the best explanation to reassure her?
A. “The test uses a fixed passing score and stops when you
reach that score with confidence.”
B. “The exam is computer adaptive and ends when your ability
,is clearly above or below the passing standard.”
C. “Pearson stops the test early only when there is a technical
problem; otherwise it always goes to the maximum items.”
D. “The testing algorithm compares you to other candidates
and stops after average performance is reached.”
Correct Answer: B
Rationales:
Correct (B): The NCLEX uses computer adaptive testing (CAT);
the test algorithm continues selecting items until it can
determine with statistical confidence that the candidate’s ability
is above (pass) or below (fail) the passing standard. This
explains an early stop and pass result.
Incorrect (A): Misstates mechanism—there is no single fixed
raw score; the CAT uses an ability estimate relative to a
standard, not a fixed numeric cutoff.
Incorrect (C): Early stopping is not limited to technical
problems; it commonly occurs when the candidate’s ability is
clearly established.
Incorrect (D): The CAT does not stop based on “average”
performance compared to other candidates; it compares the
candidate’s ability to the established passing standard.
Teaching point: CAT stops when it can statistically confirm
ability relative to the passing standard.
Citation: Billings, D. M., & Hensel, D. (2024). Lippincott Q&A
Review for NCLEX-RN (14th ed.). Wolters Kluwer. Ch. 1.
,2
Reference: Ch. 1 — The NCLEX-RN® Licensing Examination —
Test Plan & Practice Analysis
Stem: A nurse educator developing an NCLEX review course
wants to align questions with the current test plan. Which
approach best ensures alignment with the NCLEX test plan and
practice analysis?
A. Include more pharmacology recall items because drug
knowledge is most important.
B. Base question topics and cognitive level on the test plan’s
client needs and practice analysis outcomes.
C. Use only factual content from textbooks without scenario-
based application.
D. Focus exclusively on procedural skills checklists since the
exam tests performance.
Correct Answer: B
Rationales:
Correct (B): The NCLEX test plan is founded on practice analysis
and organizes content by client needs, cognitive levels, and
clinical judgment requirements—so aligning questions to those
domains ensures validity.
Incorrect (A): Overemphasizing one content area
(pharmacology) risks poor alignment with the distributed
content of the test plan.
Incorrect (C): Pure recall questions do not reflect NCLEX
emphasis on clinical judgment and scenario-based application.
, Incorrect (D): While skills are important, the NCLEX tests clinical
judgment via scenarios, not procedural checklists alone.
Teaching point: Build items to the test plan’s client-needs
categories and cognitive objectives.
Citation: Billings & Hensel (2024). Ch. 1.
3
Reference: Ch. 1 — The NCLEX-RN® Licensing Examination —
Computer Use and Screen Design
Stem: A candidate arrives at the test center concerned about
using a computer for the first time. Which action by the testing
center staff best supports candidate readiness before the exam
begins?
A. Require the candidate to complete a full practice CAT exam
of 100 items.
B. Provide a short tutorial on computer functions and on-screen
tools before testing.
C. Offer printed copies of all on-screen questions for review.
D. Reduce the testing time to accommodate unfamiliarity.
Correct Answer: B
Rationales:
Correct (B): Test centers provide a tutorial or orientation to
computer functions and on-screen tools so candidates can
navigate the exam interface; this supports test security and fair
access.
