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: Understanding the Pyramid to Success
A nursing graduate has six weeks remaining before the NCLEX-RN®
examination. The graduate has been answering practice questions but has
not reviewed incorrect answers, established a study schedule, or identified
weak content areas. Which action best supports a structured approach to
examination success?
A. Complete as many practice questions as possible without reviewing
explanations.
B. Develop a study plan based on identified learning needs, use active
practice, and evaluate progress regularly.
C. Concentrate exclusively on memorizing normal laboratory values during
the final six weeks.
D. Delay practice examinations until all nursing content has been
reviewed.
Correct Answer: B — Develop a study plan based on identified learning
needs, use active practice, and evaluate progress regularly.
1
,Rationale: Effective examination preparation combines planning,
consistent study, active retrieval, practice-question analysis, and ongoing
evaluation. Reviewing incorrect answers helps the candidate identify
knowledge gaps and correct faulty reasoning. A structured approach also
helps the candidate allocate time to areas requiring additional attention.
Distractor Rationales:
• A. Incorrect: Completing questions without analyzing rationales may
reinforce misconceptions and limit learning.
• B. Correct: A targeted, evaluated study plan promotes purposeful
preparation and continuous improvement.
• C. Incorrect: Laboratory values are only one component of nursing
knowledge and should not replace broader preparation.
• D. Incorrect: Practice questions can identify weaknesses early and
should be integrated throughout the preparation process.
Key Teaching Point: Effective NCLEX preparation emphasizes consistent
study, active learning, clinical reasoning, and analysis of mistakes rather
than question volume alone.
Cognitive Level: Application
NCLEX-RN® Client Needs Category: Management of Care
Nursing Process: Evaluation
Clinical Judgment Focus: Evaluate Outcomes
Question 2: Understanding Computer Adaptive Testing
Which statement best describes computer adaptive testing (CAT) as used
in the NCLEX-RN® examination?
A. Every candidate receives the same questions in the same order.
B. Candidates select the questions they wish to answer from a question
bank.
2
,C. The examination adjusts the difficulty of subsequently administered
items in response to the candidate's performance.
D. The examination determines the result solely by calculating the
percentage of questions answered correctly.
Correct Answer: C — The examination adjusts the difficulty of
subsequently administered items in response to the candidate's
performance.
Rationale: CAT uses the candidate's responses and the examination's
measurement model to select subsequent items that provide information
about the candidate's nursing competence. Candidates may receive
different questions and different sequences. The passing decision is based
on the applicable ability-estimation and decision rules, not simply on a raw
percentage correct.
Distractor Rationales:
• A. Incorrect: CAT does not require every candidate to receive an
identical sequence of questions.
• B. Incorrect: The candidate does not choose which questions
appear.
• C. Correct: Adaptive item selection is the defining feature of CAT.
• D. Incorrect: A simple percentage-correct calculation does not
adequately describe the NCLEX-RN CAT passing process.
Key Teaching Point: CAT individualizes item selection to estimate the
candidate's ability relative to the examination's passing standard.
Cognitive Level: Recall
NCLEX-RN® Client Needs Category: Management of Care
Nursing Process: Assessment
Clinical Judgment Focus: Not primarily CJMM-focused
3
, Question 3: Purpose of the NCLEX-RN Test Plan
A candidate asks why the NCLEX-RN examination includes questions from
several nursing practice areas instead of concentrating on the candidate's
strongest specialty. Which explanation is most accurate?
A. The test plan organizes examination content around entry-level nursing
competencies and designated client-needs areas.
B. The test plan ensures that all candidates receive identical questions
covering identical clinical situations.
C. The test plan focuses primarily on advanced specialty knowledge
acquired after licensure.
D. The test plan allows each candidate to choose which client-needs
categories will be assessed.
Correct Answer: A — The test plan organizes examination content around
entry-level nursing competencies and designated client-needs areas.
Rationale: The NCLEX-RN test plan establishes the framework for
assessing entry-level registered nursing competence. Its client-needs
categories and related content guide examination development and
content distribution. The plan is not designed to assess only one specialty
or allow candidates to select their examination content.
Distractor Rationales:
• A. Correct: The test plan supports systematic assessment of the
knowledge and skills needed for safe entry-level registered nursing
practice.
• B. Incorrect: Candidates do not necessarily receive identical items,
particularly in an adaptive examination.
• C. Incorrect: The examination focuses on entry-level RN practice, not
advanced specialty expertise.
4
NCLEX-RN® EXAMINATION
8TH EDITION
AUTHOR(S)LINDA SILVESTRI
Unit I: NCLEX-RN® Exam Preparation
Chapter 1: The NCLEX-RN® Examination
Question 1: Understanding the Pyramid to Success
A nursing graduate has six weeks remaining before the NCLEX-RN®
examination. The graduate has been answering practice questions but has
not reviewed incorrect answers, established a study schedule, or identified
weak content areas. Which action best supports a structured approach to
examination success?
A. Complete as many practice questions as possible without reviewing
explanations.
B. Develop a study plan based on identified learning needs, use active
practice, and evaluate progress regularly.
C. Concentrate exclusively on memorizing normal laboratory values during
the final six weeks.
D. Delay practice examinations until all nursing content has been
reviewed.
Correct Answer: B — Develop a study plan based on identified learning
needs, use active practice, and evaluate progress regularly.
1
,Rationale: Effective examination preparation combines planning,
consistent study, active retrieval, practice-question analysis, and ongoing
evaluation. Reviewing incorrect answers helps the candidate identify
knowledge gaps and correct faulty reasoning. A structured approach also
helps the candidate allocate time to areas requiring additional attention.
Distractor Rationales:
• A. Incorrect: Completing questions without analyzing rationales may
reinforce misconceptions and limit learning.
• B. Correct: A targeted, evaluated study plan promotes purposeful
preparation and continuous improvement.
• C. Incorrect: Laboratory values are only one component of nursing
knowledge and should not replace broader preparation.
• D. Incorrect: Practice questions can identify weaknesses early and
should be integrated throughout the preparation process.
Key Teaching Point: Effective NCLEX preparation emphasizes consistent
study, active learning, clinical reasoning, and analysis of mistakes rather
than question volume alone.
Cognitive Level: Application
NCLEX-RN® Client Needs Category: Management of Care
Nursing Process: Evaluation
Clinical Judgment Focus: Evaluate Outcomes
Question 2: Understanding Computer Adaptive Testing
Which statement best describes computer adaptive testing (CAT) as used
in the NCLEX-RN® examination?
A. Every candidate receives the same questions in the same order.
B. Candidates select the questions they wish to answer from a question
bank.
2
,C. The examination adjusts the difficulty of subsequently administered
items in response to the candidate's performance.
D. The examination determines the result solely by calculating the
percentage of questions answered correctly.
Correct Answer: C — The examination adjusts the difficulty of
subsequently administered items in response to the candidate's
performance.
Rationale: CAT uses the candidate's responses and the examination's
measurement model to select subsequent items that provide information
about the candidate's nursing competence. Candidates may receive
different questions and different sequences. The passing decision is based
on the applicable ability-estimation and decision rules, not simply on a raw
percentage correct.
Distractor Rationales:
• A. Incorrect: CAT does not require every candidate to receive an
identical sequence of questions.
• B. Incorrect: The candidate does not choose which questions
appear.
• C. Correct: Adaptive item selection is the defining feature of CAT.
• D. Incorrect: A simple percentage-correct calculation does not
adequately describe the NCLEX-RN CAT passing process.
Key Teaching Point: CAT individualizes item selection to estimate the
candidate's ability relative to the examination's passing standard.
Cognitive Level: Recall
NCLEX-RN® Client Needs Category: Management of Care
Nursing Process: Assessment
Clinical Judgment Focus: Not primarily CJMM-focused
3
, Question 3: Purpose of the NCLEX-RN Test Plan
A candidate asks why the NCLEX-RN examination includes questions from
several nursing practice areas instead of concentrating on the candidate's
strongest specialty. Which explanation is most accurate?
A. The test plan organizes examination content around entry-level nursing
competencies and designated client-needs areas.
B. The test plan ensures that all candidates receive identical questions
covering identical clinical situations.
C. The test plan focuses primarily on advanced specialty knowledge
acquired after licensure.
D. The test plan allows each candidate to choose which client-needs
categories will be assessed.
Correct Answer: A — The test plan organizes examination content around
entry-level nursing competencies and designated client-needs areas.
Rationale: The NCLEX-RN test plan establishes the framework for
assessing entry-level registered nursing competence. Its client-needs
categories and related content guide examination development and
content distribution. The plan is not designed to assess only one specialty
or allow candidates to select their examination content.
Distractor Rationales:
• A. Correct: The test plan supports systematic assessment of the
knowledge and skills needed for safe entry-level registered nursing
practice.
• B. Incorrect: Candidates do not necessarily receive identical items,
particularly in an adaptive examination.
• C. Incorrect: The examination focuses on entry-level RN practice, not
advanced specialty expertise.
4
