,Ace the NCLEX-RN® with Saunders:
Verified MCQs, Rationales & Success
Framework
Table of Contents
📘 NCLEX-RN® Preparation – Table of Contents
Unit & Chapter Title
UNIT I: NCLEX-RN®
Preparation
Clinical Judgment and the NCLEX-RN®
Chapter 1
Examination
– The Pyramid to Success
– The Examination Process
– Computer Adaptive Testing
– Development of the Test Plan
– The Test Plan
– Types of Questions and Scoring
– Registration and Authorization to
Test
,Unit & Chapter Title
– Changing Your Appointment
– Day of Examination & Testing
Accommodations
– Testing Center & NGN Test Design
– Pass-or-Fail Decisions & Results
– Candidate Performance Report
– Nurse Licensure Compact &
International Nurse
Chapter 2 Self-Efficacy and Profiles to Success
– Pyramid to Success
– Increasing Self-Efficacy
– Developing Control
– Building Confidence
The NCLEX-RN® Examination: A
Chapter 3
Graduate’s Perspective
– NGN Reflections by Madison Drew
Mahon, BSN, RN
Clinical Judgment and Test-Taking
Chapter 4
Strategies
,| UNIT II: Client Needs | |
| Chapter 5 | Client Needs and the NCLEX-RN® Test Plan |
| | – Physiological Integrity |
| | – Safe and Effective Care Environment |
| | – Health Promotion and Maintenance |
| | – Psychosocial Integrity |
| Chapter 6 | Physiological Integrity Practice Questions |
| Chapter 7 | Safe and Effective Care Environment Practice
Questions |
| Chapter 8 | Health Promotion and Maintenance Practice
Questions |
| Chapter 9 | Psychosocial Integrity Practice Questions |
| UNIT III: Integrated Processes | |
| Chapter 10 | Integrated Processes and the NCLEX-RN® Test
Plan |
| | – Caring |
| | – Clinical Judgment |
| | – Communication and Documentation |
| | – Culture and Spirituality |
| | – Nursing Process |
| | – Teaching and Learning |
| Chapter 11 | Integrated Processes Practice Questions |
| | – Caring |
| | – Communication and Documentation |
| | – Culture and Spirituality |
| | – Teaching and Learning |
| | – Nursing Process: Assessment |
,| | – Nursing Process: Analysis |
| | – Nursing Process: Planning |
| | – Nursing Process: Implementation |
| | – Nursing Process: Evaluation |
,Chapter 1: Clinical Judgment and the NCLEX-RN® Examination
(Saunders Q&A Review, 9th Ed., 2025).
1. A nursing student reviews the “Pyramid to Success” model.
Which level of the pyramid focuses on integrating critical
thinking into clinical decision making?
A. Basic care and comfort
B. Priority setting
C. Critical thinking
D. Clinical judgment
Answer: C. Critical thinking
Rationale:
Correct (C): The third level, “Critical thinking,” emphasizes
applying analysis, inference, and evaluation to client care.
A: “Basic care and comfort” is the foundational first level,
not about thinking processes.
B: “Priority setting” is the second level, addressing
ordering client needs.
D: “Clinical judgment” sits at the pyramid’s apex and is the
outcome of earlier levels, not the level itself.
2. During a seminar, a student asks which attribute is
foundational in the Pyramid to Success. The instructor replies
that it underpins all other levels. Which is it?
A. Clinical judgment
,B. Professional values
C. Evidence-based practice
D. Basic care and comfort
Answer: B. Professional values
Rationale:
Correct (B): Professional values form the base of the
pyramid, guiding ethics and behaviors.
A: Clinical judgment is the apex, not the base.
C: Evidence-based practice is part of higher levels, not
foundational.
D: Basic care and comfort is the first “skill” level, above
values.
3. A new nurse applies the Pyramid to Success. Which action
exemplifies using “priority setting”?
A. Following hospital policies for hand hygiene
B. Identifying the most urgent client problem in a
multiple-client assignment
C. Documenting all vital signs
D. Reflecting on one’s own biases
Answer: B. Identifying the most urgent client problem in a
multiple-client assignment
Rationale:
, Correct (B): Priority setting involves ranking client
problems by urgency.
A: Hand hygiene is basic care/comfort, not priority setting.
C: Documentation is fundamental care, not decision
making.
D: Reflection on biases relates to values and critical
thinking, not priority setting.
4. A nurse leader wants to foster “evidence-based practice” in
her team, which corresponds to which pyramid level?
A. Level 1: Basic care and comfort
B. Level 2: Priority setting
C. Level 3: Critical thinking
D. Level 4: Evidence-based practice
Answer: D. Level 4: Evidence-based practice
Rationale:
Correct (D): The fourth level is explicitly “Evidence-based
practice.”
A–C: Levels 1–3 cover care basics, priority, and critical
thinking only.
5. Which statement best describes the apex of the Pyramid to
Success?
A. It ensures all tasks are completed.
,B. It represents professional values.
C. It is the application of previous levels into safe, effective
client care.
D. It focuses solely on critical thinking skills.
Answer: C. It is the application of previous levels into safe,
effective client care.
Rationale:
Correct (C): The apex, clinical judgment, integrates all
levels to make decisions.
A: Task completion is not the apex concept.
B: Professional values are foundational, not apex.
D: Critical thinking is level 3, not the apex.
6. A student confuses “clinical judgment” with simple task
completion. Which pyramid level directly precedes clinical
judgment?
A. Basic care and comfort
B. Priority setting
C. Evidence-based practice
D. Critical thinking
Answer: C. Evidence-based practice
Rationale:
Correct (C): Level 4 (evidence-based practice) directly
precedes level 5, clinical judgment.
, A, B, D: These are lower levels: 1, 2, and 3, respectively.
7. When reflecting on a case, a nurse asks, “What does this
evidence mean for my patient?” Which pyramid level does this
reflect?
A. Basic care and comfort
B. Priority setting
C. Critical thinking
D. Evidence-based practice
Answer: D. Evidence-based practice
Rationale:
Correct (D): Evaluating evidence’s relevance is core to
evidence-based practice.
A & B: Too rudimentary.
C: Critical thinking analyzes data but doesn’t explicitly
integrate research evidence.
8. A preceptor asks, “How do you prioritize tasks?” Which
pyramid level are they assessing?
A. Level 1
B. Level 2
C. Level 4
D. Level 5
Verified MCQs, Rationales & Success
Framework
Table of Contents
📘 NCLEX-RN® Preparation – Table of Contents
Unit & Chapter Title
UNIT I: NCLEX-RN®
Preparation
Clinical Judgment and the NCLEX-RN®
Chapter 1
Examination
– The Pyramid to Success
– The Examination Process
– Computer Adaptive Testing
– Development of the Test Plan
– The Test Plan
– Types of Questions and Scoring
– Registration and Authorization to
Test
,Unit & Chapter Title
– Changing Your Appointment
– Day of Examination & Testing
Accommodations
– Testing Center & NGN Test Design
– Pass-or-Fail Decisions & Results
– Candidate Performance Report
– Nurse Licensure Compact &
International Nurse
Chapter 2 Self-Efficacy and Profiles to Success
– Pyramid to Success
– Increasing Self-Efficacy
– Developing Control
– Building Confidence
The NCLEX-RN® Examination: A
Chapter 3
Graduate’s Perspective
– NGN Reflections by Madison Drew
Mahon, BSN, RN
Clinical Judgment and Test-Taking
Chapter 4
Strategies
,| UNIT II: Client Needs | |
| Chapter 5 | Client Needs and the NCLEX-RN® Test Plan |
| | – Physiological Integrity |
| | – Safe and Effective Care Environment |
| | – Health Promotion and Maintenance |
| | – Psychosocial Integrity |
| Chapter 6 | Physiological Integrity Practice Questions |
| Chapter 7 | Safe and Effective Care Environment Practice
Questions |
| Chapter 8 | Health Promotion and Maintenance Practice
Questions |
| Chapter 9 | Psychosocial Integrity Practice Questions |
| UNIT III: Integrated Processes | |
| Chapter 10 | Integrated Processes and the NCLEX-RN® Test
Plan |
| | – Caring |
| | – Clinical Judgment |
| | – Communication and Documentation |
| | – Culture and Spirituality |
| | – Nursing Process |
| | – Teaching and Learning |
| Chapter 11 | Integrated Processes Practice Questions |
| | – Caring |
| | – Communication and Documentation |
| | – Culture and Spirituality |
| | – Teaching and Learning |
| | – Nursing Process: Assessment |
,| | – Nursing Process: Analysis |
| | – Nursing Process: Planning |
| | – Nursing Process: Implementation |
| | – Nursing Process: Evaluation |
,Chapter 1: Clinical Judgment and the NCLEX-RN® Examination
(Saunders Q&A Review, 9th Ed., 2025).
1. A nursing student reviews the “Pyramid to Success” model.
Which level of the pyramid focuses on integrating critical
thinking into clinical decision making?
A. Basic care and comfort
B. Priority setting
C. Critical thinking
D. Clinical judgment
Answer: C. Critical thinking
Rationale:
Correct (C): The third level, “Critical thinking,” emphasizes
applying analysis, inference, and evaluation to client care.
A: “Basic care and comfort” is the foundational first level,
not about thinking processes.
B: “Priority setting” is the second level, addressing
ordering client needs.
D: “Clinical judgment” sits at the pyramid’s apex and is the
outcome of earlier levels, not the level itself.
2. During a seminar, a student asks which attribute is
foundational in the Pyramid to Success. The instructor replies
that it underpins all other levels. Which is it?
A. Clinical judgment
,B. Professional values
C. Evidence-based practice
D. Basic care and comfort
Answer: B. Professional values
Rationale:
Correct (B): Professional values form the base of the
pyramid, guiding ethics and behaviors.
A: Clinical judgment is the apex, not the base.
C: Evidence-based practice is part of higher levels, not
foundational.
D: Basic care and comfort is the first “skill” level, above
values.
3. A new nurse applies the Pyramid to Success. Which action
exemplifies using “priority setting”?
A. Following hospital policies for hand hygiene
B. Identifying the most urgent client problem in a
multiple-client assignment
C. Documenting all vital signs
D. Reflecting on one’s own biases
Answer: B. Identifying the most urgent client problem in a
multiple-client assignment
Rationale:
, Correct (B): Priority setting involves ranking client
problems by urgency.
A: Hand hygiene is basic care/comfort, not priority setting.
C: Documentation is fundamental care, not decision
making.
D: Reflection on biases relates to values and critical
thinking, not priority setting.
4. A nurse leader wants to foster “evidence-based practice” in
her team, which corresponds to which pyramid level?
A. Level 1: Basic care and comfort
B. Level 2: Priority setting
C. Level 3: Critical thinking
D. Level 4: Evidence-based practice
Answer: D. Level 4: Evidence-based practice
Rationale:
Correct (D): The fourth level is explicitly “Evidence-based
practice.”
A–C: Levels 1–3 cover care basics, priority, and critical
thinking only.
5. Which statement best describes the apex of the Pyramid to
Success?
A. It ensures all tasks are completed.
,B. It represents professional values.
C. It is the application of previous levels into safe, effective
client care.
D. It focuses solely on critical thinking skills.
Answer: C. It is the application of previous levels into safe,
effective client care.
Rationale:
Correct (C): The apex, clinical judgment, integrates all
levels to make decisions.
A: Task completion is not the apex concept.
B: Professional values are foundational, not apex.
D: Critical thinking is level 3, not the apex.
6. A student confuses “clinical judgment” with simple task
completion. Which pyramid level directly precedes clinical
judgment?
A. Basic care and comfort
B. Priority setting
C. Evidence-based practice
D. Critical thinking
Answer: C. Evidence-based practice
Rationale:
Correct (C): Level 4 (evidence-based practice) directly
precedes level 5, clinical judgment.
, A, B, D: These are lower levels: 1, 2, and 3, respectively.
7. When reflecting on a case, a nurse asks, “What does this
evidence mean for my patient?” Which pyramid level does this
reflect?
A. Basic care and comfort
B. Priority setting
C. Critical thinking
D. Evidence-based practice
Answer: D. Evidence-based practice
Rationale:
Correct (D): Evaluating evidence’s relevance is core to
evidence-based practice.
A & B: Too rudimentary.
C: Critical thinking analyzes data but doesn’t explicitly
integrate research evidence.
8. A preceptor asks, “How do you prioritize tasks?” Which
pyramid level are they assessing?
A. Level 1
B. Level 2
C. Level 4
D. Level 5
