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)
Question (stem)
A candidate has completed 50 items on the NCLEX and notices
that most subsequent questions seem harder and more
complex than earlier ones. The candidate grows anxious and is
considering changing earlier answers that were marked as
correct. What is the nurse educator’s best explanation to relieve
the candidate’s concern?
,A. The test is identifying weaker areas; changing earlier answers
may help the computer re-estimate ability.
B. CAT increases item difficulty after correct responses to
pinpoint ability; it does not mean failure. (Correct)
C. The computer randomly assigns harder questions to
candidates it intends to fail.
D. You should stop answering and request to restart the exam
with easier questions.
Correct answer: B
Rationale — Correct (3–4 sentences)
Computerized adaptive testing adapts item difficulty to the
candidate’s estimated ability: when earlier items are answered
correctly, the algorithm presents more challenging items to
refine the ability estimate. Seeing harder items is an expected
feature of CAT and does not by itself indicate failure. The
priority is to continue applying clinical judgment to each item
rather than changing previous answers, which the CAT
algorithm already used to update its estimate.
Rationale — Incorrect
A. Changing earlier answers is rarely helpful and can degrade
performance; CAT uses responses as given to update ability.
C. The algorithm is not designed to “intend” failure; it adapts to
accurately estimate ability.
D. Requests to restart because questions feel hard are not
granted; restarting would invalidate the exam.
,Teaching point (≤20 words)
CAT presents harder items after correct answers — harder
questions ≠ automatic failure.
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 — Special
Accommodations
Question (stem)
A candidate with documented ADHD asks whether they should
schedule the NCLEX immediately and bring documentation to
the test center for extra time. Which action is the most
appropriate next step?
A. Schedule the exam now at any Pearson VUE site and bring
documentation to show on test day.
B. Contact the state board to request accommodations and
obtain Authorization to Test (ATT) before scheduling. (Correct)
C. Schedule the exam now and ask the test center on the exam
day for extra time.
D. Hire a private proctor to provide extra time at the test center.
Correct answer: B
, Rationale — Correct (3–4 sentences)
Special accommodations must be requested and approved by
the regulatory/licensing board (or its designated process)
before an ATT for the accommodated exam is issued. The state
board will review documentation and coordinate with Pearson
VUE for approved accommodations; candidates cannot obtain
approved extra time by simply bringing paperwork to the test
center. Proper pre-approval protects exam security and ensures
lawful accommodation.
Rationale — Incorrect
A. Scheduling without board approval risks denial or inability to
test under accommodation.
C. Test center staff cannot grant extra time at check-in;
accommodations require prior authorization.
D. Private proctors are not allowed; testing must occur within
approved Pearson/NCSBN procedures.
Teaching point
Request accommodations through your licensing board before
scheduling the NCLEX.
Citation
Billings, D. M., & Hensel, D. (2024). Lippincott Q&A Review for
NCLEX-RN (14th ed.). Wolters Kluwer. Ch. 1.
3) Reference
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)
Question (stem)
A candidate has completed 50 items on the NCLEX and notices
that most subsequent questions seem harder and more
complex than earlier ones. The candidate grows anxious and is
considering changing earlier answers that were marked as
correct. What is the nurse educator’s best explanation to relieve
the candidate’s concern?
,A. The test is identifying weaker areas; changing earlier answers
may help the computer re-estimate ability.
B. CAT increases item difficulty after correct responses to
pinpoint ability; it does not mean failure. (Correct)
C. The computer randomly assigns harder questions to
candidates it intends to fail.
D. You should stop answering and request to restart the exam
with easier questions.
Correct answer: B
Rationale — Correct (3–4 sentences)
Computerized adaptive testing adapts item difficulty to the
candidate’s estimated ability: when earlier items are answered
correctly, the algorithm presents more challenging items to
refine the ability estimate. Seeing harder items is an expected
feature of CAT and does not by itself indicate failure. The
priority is to continue applying clinical judgment to each item
rather than changing previous answers, which the CAT
algorithm already used to update its estimate.
Rationale — Incorrect
A. Changing earlier answers is rarely helpful and can degrade
performance; CAT uses responses as given to update ability.
C. The algorithm is not designed to “intend” failure; it adapts to
accurately estimate ability.
D. Requests to restart because questions feel hard are not
granted; restarting would invalidate the exam.
,Teaching point (≤20 words)
CAT presents harder items after correct answers — harder
questions ≠ automatic failure.
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 — Special
Accommodations
Question (stem)
A candidate with documented ADHD asks whether they should
schedule the NCLEX immediately and bring documentation to
the test center for extra time. Which action is the most
appropriate next step?
A. Schedule the exam now at any Pearson VUE site and bring
documentation to show on test day.
B. Contact the state board to request accommodations and
obtain Authorization to Test (ATT) before scheduling. (Correct)
C. Schedule the exam now and ask the test center on the exam
day for extra time.
D. Hire a private proctor to provide extra time at the test center.
Correct answer: B
, Rationale — Correct (3–4 sentences)
Special accommodations must be requested and approved by
the regulatory/licensing board (or its designated process)
before an ATT for the accommodated exam is issued. The state
board will review documentation and coordinate with Pearson
VUE for approved accommodations; candidates cannot obtain
approved extra time by simply bringing paperwork to the test
center. Proper pre-approval protects exam security and ensures
lawful accommodation.
Rationale — Incorrect
A. Scheduling without board approval risks denial or inability to
test under accommodation.
C. Test center staff cannot grant extra time at check-in;
accommodations require prior authorization.
D. Private proctors are not allowed; testing must occur within
approved Pearson/NCSBN procedures.
Teaching point
Request accommodations through your licensing board before
scheduling the NCLEX.
Citation
Billings, D. M., & Hensel, D. (2024). Lippincott Q&A Review for
NCLEX-RN (14th ed.). Wolters Kluwer. Ch. 1.
3) Reference
