NCLEX-RN
14TH EDITION
• AUTHOR(S)DIANE BILLINGS;
DESIREE HENSEL
TEST BANK
1
Reference
Ch. 1 — The NCLEX-RN® Licensing Examination — Test Plan &
Practice Analysis
Stem
A nurse educator is coaching a senior nursing student about the
NCLEX-RN test plan. The student asks why the NCLEX content
percentages change over time. Which explanation best aligns
with test plan development?
,A. The test plan is updated based solely on new medical
discoveries.
B. The test plan is revised using a national practice analysis of
entry-level competencies.
C. The test plan percentages change annually according to exam
pass rates.
D. The test plan is adjusted to reflect the most popular textbook
content.
Correct Answer: B
Rationales
Correct (B): The NCLEX test plan is revised based on periodic
national practice analyses that identify entry-level RN
competencies; this drives content weightings and ensures the
exam reflects actual practice. This explains percentage changes
and aligns with validity standards.
Incorrect (A): Medical discoveries influence practice but the
test plan is not updated solely for scientific advances—it's
based on practice analysis.
Incorrect (C): Pass rates do not directly determine content
percentages; pass rates measure outcomes, not content
domains.
Incorrect (D): Textbook popularity is not used to set test plan
content; authoritative practice analysis is the basis.
Teaching Point
Test plan updates stem from national practice analyses of entry-
level RN tasks and responsibilities.
,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 — Computer
Adaptive Testing (CAT)
Stem
During a review session, a student asks how computer adaptive
testing (CAT) affects item selection. Which statement best
describes CAT’s immediate effect on the examinee’s test
experience?
A. The computer gives progressively easier items after each
correct response.
B. Item difficulty adjusts based on previous responses to
estimate competence.
C. Examinees can return to earlier items for review because CAT
is linear.
D. All examinees receive the same set of items randomly
selected from a bank.
Correct Answer: B
Rationales
Correct (B): CAT adjusts item difficulty in real time based on
prior responses to better estimate the candidate’s ability level;
, this produces a tailored set of items and determines pass/fail
with statistical confidence.
Incorrect (A): CAT typically presents harder items after correct
answers and easier after incorrect ones as it homes in on
ability; it does not always give easier items after correct
responses.
Incorrect (C): In CAT, examinees cannot go back to change
previous answers—items are adaptive and usually locked once
answered.
Incorrect (D): CAT delivers individualized items based on
performance, not the same random set to all examinees.
Teaching Point
CAT adapts item difficulty dynamically to estimate the
candidate’s ability level.
Citation
Billings, D. M., & Hensel, D. (2024). Lippincott Q&A Review for
NCLEX-RN (14th ed.). Wolters Kluwer. Ch. 1.
3
Reference
Ch. 1 — The NCLEX-RN® Licensing Examination — Computer
Adaptive Testing (Test Termination)
Stem
A student asked whether the NCLEX can end before the