SAUNDERS COMPREHENSIVE REVIEW FOR THE
NCLEX-RN® EXAMINATION
8TH EDITION
AUTHOR(S)LINDA SILVESTRI
Unit I: NCLEX-RN® Exam Preparation
Chapter 1: The NCLEX-RN® Examination
Question 1: The Pyramid to Success
A nursing graduate has six weeks remaining before the NCLEX-RN
examination. The graduate plans to study for 10 hours each day during the
final week but has not yet developed a study schedule or completed any
practice questions. Which action best supports a structured approach to
examination preparation?
A. Memorize as many disease definitions as possible before attempting
practice questions.
B. Develop a realistic study plan, assess knowledge gaps, practice
applying nursing concepts, and review rationales consistently.
C. Concentrate exclusively on questions recalled from previous
examination candidates.
D. Postpone practice examinations until all nursing content has been
reviewed.
Correct Answer: B. Develop a realistic study plan, assess knowledge gaps,
practice applying nursing concepts, and review rationales consistently.
1
,Rationale:
A structured preparation strategy combines organized study, identification
of knowledge gaps, active practice, and reflection on clinical reasoning.
Reviewing rationales helps the candidate understand why an answer is
correct and why alternatives are less appropriate. Consistent preparation
also makes it easier to monitor progress and adjust the study plan.
Distractor Rationales:
• A. Incorrect: Memorization is useful for foundational knowledge, but
NCLEX preparation also requires application, prioritization, and
clinical judgment.
• C. Incorrect: Recalled examination questions may be inaccurate,
unauthorized, or unrepresentative. Preparation should focus on
legitimate practice materials and underlying nursing concepts.
• D. Incorrect: Delaying all practice prevents the candidate from
identifying weaknesses early enough to address them.
Key Teaching Point: Effective preparation combines a realistic schedule,
active practice, targeted remediation, and ongoing evaluation of progress.
Cognitive Level: Application NCLEX-RN® Client Needs Category:
Management of Care Nursing Process: Planning Clinical Judgment Focus:
Generate Solutions
Question 2: The Examination Process
Which statement best describes the purpose of the NCLEX-RN
examination?
A. To determine whether a candidate has memorized the largest amount of
nursing information.
B. To rank all candidates according to their performance relative to other
candidates.
2
,C. To assess whether a candidate meets the required standard for entry-
level registered nursing practice.
D. To verify that a candidate has completed every possible clinical
procedure during nursing school.
Correct Answer: C. To assess whether a candidate meets the required
standard for entry-level registered nursing practice.
Rationale:
The NCLEX-RN is a licensure examination designed to assess whether a
candidate demonstrates the nursing knowledge and clinical judgment
needed for safe, effective entry-level registered nursing practice. Its
purpose is not simply to measure memorization or rank candidates against
one another.
Distractor Rationales:
• A. Incorrect: Recall contributes to nursing competence, but the
examination also assesses application, analysis, and clinical
decision-making.
• B. Incorrect: The examination uses a passing standard rather than a
simple ranking system in which a predetermined percentage of
candidates must fail.
• D. Incorrect: The examination assesses competence through test
items; it does not require every possible clinical procedure to be
performed during the examination.
Key Teaching Point: The NCLEX-RN is a licensure assessment of entry-level
nursing competence, not a competition among candidates.
Cognitive Level: Recall NCLEX-RN® Client Needs Category: Management of
Care Nursing Process: Evaluation Clinical Judgment Focus: Not primarily
CJMM-focused
Question 3: Computer Adaptive Testing
3
, A candidate asks the nurse educator how computer adaptive testing differs
from a traditional fixed-form examination. Which explanation is most
accurate?
A. The computer selects subsequent items in response to the candidate's
estimated ability, using the examination's measurement rules.
B. The computer gives every candidate the same questions in the same
order.
C. The computer allows candidates to change previously submitted
answers whenever they wish.
D. The computer determines the result solely from the percentage of
questions answered correctly.
Correct Answer: A. The computer selects subsequent items in response to
the candidate's estimated ability, using the examination's measurement
rules.
Rationale:
Computer adaptive testing (CAT) uses the candidate's performance on
administered items to update an estimate of ability and select subsequent
items that contribute useful information to the measurement process. The
examination is designed to determine whether the candidate's ability is
above or below the required passing standard with sufficient statistical
confidence, subject to the examination's stopping rules.
Distractor Rationales:
• B. Incorrect: CAT does not require every candidate to receive an
identical sequence of items.
• C. Incorrect: Candidates must follow the examination software's
rules. NCLEX candidates should not assume they can return to
previously submitted items.
4
NCLEX-RN® EXAMINATION
8TH EDITION
AUTHOR(S)LINDA SILVESTRI
Unit I: NCLEX-RN® Exam Preparation
Chapter 1: The NCLEX-RN® Examination
Question 1: The Pyramid to Success
A nursing graduate has six weeks remaining before the NCLEX-RN
examination. The graduate plans to study for 10 hours each day during the
final week but has not yet developed a study schedule or completed any
practice questions. Which action best supports a structured approach to
examination preparation?
A. Memorize as many disease definitions as possible before attempting
practice questions.
B. Develop a realistic study plan, assess knowledge gaps, practice
applying nursing concepts, and review rationales consistently.
C. Concentrate exclusively on questions recalled from previous
examination candidates.
D. Postpone practice examinations until all nursing content has been
reviewed.
Correct Answer: B. Develop a realistic study plan, assess knowledge gaps,
practice applying nursing concepts, and review rationales consistently.
1
,Rationale:
A structured preparation strategy combines organized study, identification
of knowledge gaps, active practice, and reflection on clinical reasoning.
Reviewing rationales helps the candidate understand why an answer is
correct and why alternatives are less appropriate. Consistent preparation
also makes it easier to monitor progress and adjust the study plan.
Distractor Rationales:
• A. Incorrect: Memorization is useful for foundational knowledge, but
NCLEX preparation also requires application, prioritization, and
clinical judgment.
• C. Incorrect: Recalled examination questions may be inaccurate,
unauthorized, or unrepresentative. Preparation should focus on
legitimate practice materials and underlying nursing concepts.
• D. Incorrect: Delaying all practice prevents the candidate from
identifying weaknesses early enough to address them.
Key Teaching Point: Effective preparation combines a realistic schedule,
active practice, targeted remediation, and ongoing evaluation of progress.
Cognitive Level: Application NCLEX-RN® Client Needs Category:
Management of Care Nursing Process: Planning Clinical Judgment Focus:
Generate Solutions
Question 2: The Examination Process
Which statement best describes the purpose of the NCLEX-RN
examination?
A. To determine whether a candidate has memorized the largest amount of
nursing information.
B. To rank all candidates according to their performance relative to other
candidates.
2
,C. To assess whether a candidate meets the required standard for entry-
level registered nursing practice.
D. To verify that a candidate has completed every possible clinical
procedure during nursing school.
Correct Answer: C. To assess whether a candidate meets the required
standard for entry-level registered nursing practice.
Rationale:
The NCLEX-RN is a licensure examination designed to assess whether a
candidate demonstrates the nursing knowledge and clinical judgment
needed for safe, effective entry-level registered nursing practice. Its
purpose is not simply to measure memorization or rank candidates against
one another.
Distractor Rationales:
• A. Incorrect: Recall contributes to nursing competence, but the
examination also assesses application, analysis, and clinical
decision-making.
• B. Incorrect: The examination uses a passing standard rather than a
simple ranking system in which a predetermined percentage of
candidates must fail.
• D. Incorrect: The examination assesses competence through test
items; it does not require every possible clinical procedure to be
performed during the examination.
Key Teaching Point: The NCLEX-RN is a licensure assessment of entry-level
nursing competence, not a competition among candidates.
Cognitive Level: Recall NCLEX-RN® Client Needs Category: Management of
Care Nursing Process: Evaluation Clinical Judgment Focus: Not primarily
CJMM-focused
Question 3: Computer Adaptive Testing
3
, A candidate asks the nurse educator how computer adaptive testing differs
from a traditional fixed-form examination. Which explanation is most
accurate?
A. The computer selects subsequent items in response to the candidate's
estimated ability, using the examination's measurement rules.
B. The computer gives every candidate the same questions in the same
order.
C. The computer allows candidates to change previously submitted
answers whenever they wish.
D. The computer determines the result solely from the percentage of
questions answered correctly.
Correct Answer: A. The computer selects subsequent items in response to
the candidate's estimated ability, using the examination's measurement
rules.
Rationale:
Computer adaptive testing (CAT) uses the candidate's performance on
administered items to update an estimate of ability and select subsequent
items that contribute useful information to the measurement process. The
examination is designed to determine whether the candidate's ability is
above or below the required passing standard with sufficient statistical
confidence, subject to the examination's stopping rules.
Distractor Rationales:
• B. Incorrect: CAT does not require every candidate to receive an
identical sequence of items.
• C. Incorrect: Candidates must follow the examination software's
rules. NCLEX candidates should not assume they can return to
previously submitted items.
4
