SAUNDERS COMPREHENSIVE REVIEW FOR THE
NCLEX-PN® EXAMINATION
9TH EDITION
AUTHOR(S)LINDA ANNE SILVESTRI; ANGELA
SILVESTRI
TEST BANK
Question 1
Reference: Clinical Judgment and the Next Generation NCLEX (NGN)-PN® Examination
Clinical Scenario: A practical nursing student is preparing for the NCLEX-PN® examination and is
reviewing the test plan. The student asks the instructor about the primary difference between
the traditional NCLEX-PN® and the Next Generation NCLEX (NGN)-PN®. The instructor's
response focuses on the NGN's emphasis on:
Options:
A. Increasing the total number of multiple-choice questions
B. Testing knowledge of specific disease processes
C. Measuring clinical judgment through case-based items
D. Requiring computer proficiency for test completion
Correct Answer: C
Rationale:
Correct: The NGN-PN® examination places greater emphasis on measuring clinical
judgment through case-based, unfolding scenarios that require candidates to apply the
,cognitive skills of the Clinical Judgment Measurement Model (CJMM). This shift moves beyond
simple recall to evaluate a candidate's ability to recognize cues, analyze data, prioritize
hypotheses, generate solutions, take actions, and evaluate outcomes . The traditional NCLEX-
PN® already contained many multiple-choice items, but the NGN design specifically focuses on
multi-step clinical reasoning in realistic client situations.
Incorrect:
• A: The NGN did not primarily increase total multiple-choice questions; it introduced new
item types designed to measure clinical judgment.
• B: Testing specific disease processes was already present in the traditional exam; this is
not the primary distinguishing feature of the NGN-PN.
• D: Computer proficiency was already required for the computerized adaptive test (CAT);
this is not unique to the NGN.
Teaching Point: The NGN-PN® emphasizes clinical judgment through case-based items
measuring the six cognitive skills of the NCSBN Clinical Judgment Measurement Model.
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders Comprehensive Review for the NCLEX-
PN® Examination (9th ed.). Clinical Judgment and the Next Generation NCLEX (NGN)-PN®
Examination.
Question 2
Reference: Computer Adaptive Testing
Clinical Scenario: A practical nursing student is learning about the computerized adaptive
testing (CAT) format used for the NCLEX-PN® examination. The student correctly understands
that the CAT system:
Options:
A. Presents the same set of questions to every candidate
,B. Selects questions based on the candidate's ability level
C. Allows candidates to skip difficult questions and return later
D. Provides a fixed number of questions for all test-takers
Correct Answer: B
Rationale:
Correct: The NCLEX-PN® uses computerized adaptive testing (CAT), which selects questions
based on the candidate's ability level. The computer continuously estimates the candidate's
ability and chooses questions that are appropriate for that ability level . This adaptive
technology allows the examination to accurately measure a candidate's nursing competence
with fewer questions than a fixed-length examination.
Incorrect:
• A: CAT does not present the same set of questions to every candidate; the test is
individualized based on the candidate's performance.
• C: Candidates cannot skip questions on the NCLEX-PN®; they must answer each question
before proceeding.
• D: The number of questions varies based on candidate performance, not a fixed number
for all test-takers.
Teaching Point: CAT selects questions based on candidate ability level, adapting throughout the
examination to accurately measure nursing competence.
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders Comprehensive Review for the NCLEX-
PN® Examination (9th ed.). Computer Adaptive Testing.
Question 3
Reference: Client Needs
, Clinical Scenario: The practical nursing instructor is reviewing the NCLEX-PN® test plan with
students. When discussing how the examination is organized, the instructor explains that the
test plan is structured around four major categories known as:
Options:
A. Cognitive Levels
B. Integrated Processes
C. Client Needs
D. Nursing Diagnoses
Correct Answer: C
Rationale:
Correct: The NCLEX-PN® test plan is organized according to Client Needs, which are the four
major categories that reflect the nursing care needs of clients. These include Safe and Effective
Care Environment, Health Promotion and Maintenance, Psychosocial Integrity, and
Physiological Integrity. The Client Needs framework ensures that the examination measures
entry-level competencies required for safe nursing practice .
Incorrect:
• A: Cognitive Levels refer to the intellectual demands of questions (e.g., recall,
application, analysis) but are not the organizing framework for the test plan.
• B: Integrated Processes are nursing behaviors that are woven throughout the test plan
but are not the primary organizing categories.
• D: Nursing Diagnoses are used in clinical practice but are not the primary organizational
structure of the NCLEX-PN® test plan.
Teaching Point: The NCLEX-PN® test plan is organized by Client Needs categories to reflect
entry-level competencies for safe nursing practice.
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders Comprehensive Review for the NCLEX-
PN® Examination (9th ed.). Test Plan.
NCLEX-PN® EXAMINATION
9TH EDITION
AUTHOR(S)LINDA ANNE SILVESTRI; ANGELA
SILVESTRI
TEST BANK
Question 1
Reference: Clinical Judgment and the Next Generation NCLEX (NGN)-PN® Examination
Clinical Scenario: A practical nursing student is preparing for the NCLEX-PN® examination and is
reviewing the test plan. The student asks the instructor about the primary difference between
the traditional NCLEX-PN® and the Next Generation NCLEX (NGN)-PN®. The instructor's
response focuses on the NGN's emphasis on:
Options:
A. Increasing the total number of multiple-choice questions
B. Testing knowledge of specific disease processes
C. Measuring clinical judgment through case-based items
D. Requiring computer proficiency for test completion
Correct Answer: C
Rationale:
Correct: The NGN-PN® examination places greater emphasis on measuring clinical
judgment through case-based, unfolding scenarios that require candidates to apply the
,cognitive skills of the Clinical Judgment Measurement Model (CJMM). This shift moves beyond
simple recall to evaluate a candidate's ability to recognize cues, analyze data, prioritize
hypotheses, generate solutions, take actions, and evaluate outcomes . The traditional NCLEX-
PN® already contained many multiple-choice items, but the NGN design specifically focuses on
multi-step clinical reasoning in realistic client situations.
Incorrect:
• A: The NGN did not primarily increase total multiple-choice questions; it introduced new
item types designed to measure clinical judgment.
• B: Testing specific disease processes was already present in the traditional exam; this is
not the primary distinguishing feature of the NGN-PN.
• D: Computer proficiency was already required for the computerized adaptive test (CAT);
this is not unique to the NGN.
Teaching Point: The NGN-PN® emphasizes clinical judgment through case-based items
measuring the six cognitive skills of the NCSBN Clinical Judgment Measurement Model.
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders Comprehensive Review for the NCLEX-
PN® Examination (9th ed.). Clinical Judgment and the Next Generation NCLEX (NGN)-PN®
Examination.
Question 2
Reference: Computer Adaptive Testing
Clinical Scenario: A practical nursing student is learning about the computerized adaptive
testing (CAT) format used for the NCLEX-PN® examination. The student correctly understands
that the CAT system:
Options:
A. Presents the same set of questions to every candidate
,B. Selects questions based on the candidate's ability level
C. Allows candidates to skip difficult questions and return later
D. Provides a fixed number of questions for all test-takers
Correct Answer: B
Rationale:
Correct: The NCLEX-PN® uses computerized adaptive testing (CAT), which selects questions
based on the candidate's ability level. The computer continuously estimates the candidate's
ability and chooses questions that are appropriate for that ability level . This adaptive
technology allows the examination to accurately measure a candidate's nursing competence
with fewer questions than a fixed-length examination.
Incorrect:
• A: CAT does not present the same set of questions to every candidate; the test is
individualized based on the candidate's performance.
• C: Candidates cannot skip questions on the NCLEX-PN®; they must answer each question
before proceeding.
• D: The number of questions varies based on candidate performance, not a fixed number
for all test-takers.
Teaching Point: CAT selects questions based on candidate ability level, adapting throughout the
examination to accurately measure nursing competence.
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders Comprehensive Review for the NCLEX-
PN® Examination (9th ed.). Computer Adaptive Testing.
Question 3
Reference: Client Needs
, Clinical Scenario: The practical nursing instructor is reviewing the NCLEX-PN® test plan with
students. When discussing how the examination is organized, the instructor explains that the
test plan is structured around four major categories known as:
Options:
A. Cognitive Levels
B. Integrated Processes
C. Client Needs
D. Nursing Diagnoses
Correct Answer: C
Rationale:
Correct: The NCLEX-PN® test plan is organized according to Client Needs, which are the four
major categories that reflect the nursing care needs of clients. These include Safe and Effective
Care Environment, Health Promotion and Maintenance, Psychosocial Integrity, and
Physiological Integrity. The Client Needs framework ensures that the examination measures
entry-level competencies required for safe nursing practice .
Incorrect:
• A: Cognitive Levels refer to the intellectual demands of questions (e.g., recall,
application, analysis) but are not the organizing framework for the test plan.
• B: Integrated Processes are nursing behaviors that are woven throughout the test plan
but are not the primary organizing categories.
• D: Nursing Diagnoses are used in clinical practice but are not the primary organizational
structure of the NCLEX-PN® test plan.
Teaching Point: The NCLEX-PN® test plan is organized by Client Needs categories to reflect
entry-level competencies for safe nursing practice.
Citation: Silvestri, L. A., & Silvestri, A. (2026). Saunders Comprehensive Review for the NCLEX-
PN® Examination (9th ed.). Test Plan.
