SAUNDERS COMPREHENSIVE REVIEW
FOR THE NCLEX-PN® EXAMINATION
9TH EDITION
• AUTHOR(S)LINDA ANNE SILVESTRI;
ANGELA SILVESTRI
TEST BANK
1
Reference: Ch. 1 — The Pyramid to Success / Test Preparation
Strategy
Stem: A PN student has 4 weeks before the NCLEX-PN and can
either (A) read every chapter in the review book once, (B)
complete timed practice exams only, (C) alternate focused
content review with NGN-style practice case studies daily, or (D)
memorize lists of facts. Which plan should the student choose
to maximize clinical judgment readiness?
A. Read every chapter once.
B. Complete timed practice exams only.
C. Alternate focused content review with NGN-style practice
,case studies daily.
D. Memorize lists of facts.
Correct Answer: C
Rationales
• Correct (C): Alternating targeted content review with NGN-
style case practice builds cue recognition and application—
key components of the Pyramid to Success and CJMM. This
strategy aligns with PN-level priorities: practice integrating
knowledge with case scenarios.
• A: Reading passively is low-yield for application and does
not train clinical judgment.
• B: Timed practice is useful, but doing it only neglects
focused remediation of weak content needed for analysis.
• D: Memorization does not develop the ability to recognize
cues or prioritize actions and is a common exam trap.
Teaching Point: Mix focused review with NGN case practice to
build clinical judgment and exam stamina.
Citation: Silvestri, L. A., & Silvestri, A. (2024). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Ch. 1.
2
Reference: Ch. 1 — Clinical Judgment and Next Generation
NCLEX (NGN) Items / CJMM (Recognizing cues)
,Stem: During an NGN case, a client’s chart shows sudden
oxygen saturation decrease from 96% to 88% and respiratory
rate 28/min with mild use of accessory muscles. Which cue
should the PN recognize as most urgent?
A. Respiratory rate 28/min.
B. Use of accessory muscles.
C. Oxygen saturation drop to 88%.
D. The fact that the change occurred during morning rounds.
Correct Answer: C
Rationales
• Correct (C): SpO₂ 88% is the most objective indicator of
inadequate oxygenation and requires immediate nursing
attention (administer oxygen and notify provider as
appropriate). Recognizing hypoxemia is a primary cue in CJ.
• A: Elevated RR is concerning but less specific than a
measured SpO₂ of 88%.
• B: Accessory muscle use is an important cue of increased
work of breathing but secondary to measured hypoxemia.
• D: Timing is context but not the most urgent physiologic
cue.
Teaching Point: Prioritize objective physiologic data (e.g., SpO₂)
when recognizing urgent cues.
Citation: Silvestri, L. A., & Silvestri, A. (2024). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Ch. 1.
, 3
Reference: Ch. 1 — NGN Test Design / Types of NGN Items
(Case studies & partial credit)
Stem: The NGN includes case-based item sets that can assign
partial credit on complex tasks. Which NGN feature primarily
reduces the impact of random guessing?
A. Shorter total exam time.
B. Partial-credit scoring for multi-step case items.
C. Increasing the number of simple recall questions.
D. Allowing candidates to return to previous items.
Correct Answer: B
Rationales
• Correct (B): Partial-credit scoring for multi-step case items
rewards partial correct clinical reasoning and reduces the
effect of guessing, per NGN test design principles.
• A: Shorter time does not reduce guessing and could
increase pressure.
• C: More recall questions would not address the CJ skills or
guessing impact.
• D: Candidates cannot return to previous items in CAT
formats; allowing return is not an NGN feature to reduce
guessing.
FOR THE NCLEX-PN® EXAMINATION
9TH EDITION
• AUTHOR(S)LINDA ANNE SILVESTRI;
ANGELA SILVESTRI
TEST BANK
1
Reference: Ch. 1 — The Pyramid to Success / Test Preparation
Strategy
Stem: A PN student has 4 weeks before the NCLEX-PN and can
either (A) read every chapter in the review book once, (B)
complete timed practice exams only, (C) alternate focused
content review with NGN-style practice case studies daily, or (D)
memorize lists of facts. Which plan should the student choose
to maximize clinical judgment readiness?
A. Read every chapter once.
B. Complete timed practice exams only.
C. Alternate focused content review with NGN-style practice
,case studies daily.
D. Memorize lists of facts.
Correct Answer: C
Rationales
• Correct (C): Alternating targeted content review with NGN-
style case practice builds cue recognition and application—
key components of the Pyramid to Success and CJMM. This
strategy aligns with PN-level priorities: practice integrating
knowledge with case scenarios.
• A: Reading passively is low-yield for application and does
not train clinical judgment.
• B: Timed practice is useful, but doing it only neglects
focused remediation of weak content needed for analysis.
• D: Memorization does not develop the ability to recognize
cues or prioritize actions and is a common exam trap.
Teaching Point: Mix focused review with NGN case practice to
build clinical judgment and exam stamina.
Citation: Silvestri, L. A., & Silvestri, A. (2024). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Ch. 1.
2
Reference: Ch. 1 — Clinical Judgment and Next Generation
NCLEX (NGN) Items / CJMM (Recognizing cues)
,Stem: During an NGN case, a client’s chart shows sudden
oxygen saturation decrease from 96% to 88% and respiratory
rate 28/min with mild use of accessory muscles. Which cue
should the PN recognize as most urgent?
A. Respiratory rate 28/min.
B. Use of accessory muscles.
C. Oxygen saturation drop to 88%.
D. The fact that the change occurred during morning rounds.
Correct Answer: C
Rationales
• Correct (C): SpO₂ 88% is the most objective indicator of
inadequate oxygenation and requires immediate nursing
attention (administer oxygen and notify provider as
appropriate). Recognizing hypoxemia is a primary cue in CJ.
• A: Elevated RR is concerning but less specific than a
measured SpO₂ of 88%.
• B: Accessory muscle use is an important cue of increased
work of breathing but secondary to measured hypoxemia.
• D: Timing is context but not the most urgent physiologic
cue.
Teaching Point: Prioritize objective physiologic data (e.g., SpO₂)
when recognizing urgent cues.
Citation: Silvestri, L. A., & Silvestri, A. (2024). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Ch. 1.
, 3
Reference: Ch. 1 — NGN Test Design / Types of NGN Items
(Case studies & partial credit)
Stem: The NGN includes case-based item sets that can assign
partial credit on complex tasks. Which NGN feature primarily
reduces the impact of random guessing?
A. Shorter total exam time.
B. Partial-credit scoring for multi-step case items.
C. Increasing the number of simple recall questions.
D. Allowing candidates to return to previous items.
Correct Answer: B
Rationales
• Correct (B): Partial-credit scoring for multi-step case items
rewards partial correct clinical reasoning and reduces the
effect of guessing, per NGN test design principles.
• A: Shorter time does not reduce guessing and could
increase pressure.
• C: More recall questions would not address the CJ skills or
guessing impact.
• D: Candidates cannot return to previous items in CAT
formats; allowing return is not an NGN feature to reduce
guessing.
