,Trusted NCLEX-RN® Review with
Saunders: Chapter-Based MCQs and
Rationales
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. Pyramid to Success
A newly graduated nurse recalls the “Pyramid to Success” for
NCLEX preparation. Which foundational element does the base
of the pyramid represent?
A. Test-taking strategies
B. Content mastery
C. Critical thinking
D. Time management
Correct Answer: C
Rationale:
C is correct because critical thinking skills form the base,
allowing synthesis of content and application on exam
items.
A is incorrect; test-taking strategies are higher in the
pyramid.
B is content mastery, which sits above critical thinking.
D time management is a strategy, not foundational.
2. Pyramid to Success
Which statement best explains why test-taking strategies are
placed near the top of the Pyramid to Success?
A. They are the most difficult skills to teach.
B. They rely on mastery of content and critical thinking.
,C. They are useful only on exam day.
D. They replace the need for content review.
Correct Answer: B
Rationale:
B is correct: strategies build on content knowledge and
critical thinking.
A is incorrect; difficulty isn’t the criterion.
C is false: strategies are applied during study and on exam
day.
D is incorrect; strategies complement, not replace, content
review.
3. Examination Process
A candidate is completing the NCLEX application. Which action
most directly affects eligibility to sit for the exam?
A. Selecting a convenient test center
B. Submitting official transcripts to the regulatory body
C. Reviewing the NCLEX Test Plan
D. Purchasing NCLEX review materials
Correct Answer: B
Rationale:
B is correct: transcripts verify educational requirements,
determining eligibility.
A is scheduling, not eligibility.
, C and D are preparatory but don’t affect eligibility.
4. Examination Process
On test day, the candidate experiences computer issues.
According to testing policy, what should the candidate do first?
A. Restart the computer and continue testing
B. Notify the test administrator immediately
C. Wait for the system to auto-recover
D. Contact Pearson VUE customer service after leaving
Correct Answer: B
Rationale:
B is correct: the test administrator must be notified for
official troubleshooting.
A could lose exam progress.
C wastes time and may violate procedures.
D delays resolution; must be handled onsite.
5. Examination Process
After completing the NCLEX, how soon will unofficial results be
available?
A. Immediately on screen
B. Within 48 hours online
C. In 4–6 weeks by mail
D. After the candidate scores the minimum items
,Correct Answer: A
Rationale:
A is correct: CAT provides a pass/fail screen immediately.
B and C refer to official reports, not the screen result.
D misstates the process.
6. Computer Adaptive Testing (CAT)
In NCLEX CAT, the difficulty of each new question is determined
by:
A. The candidate’s previous answered items
B. Random selection within the test plan
C. Item age in the bank
D. The candidate’s test center location
Correct Answer: A
Rationale:
A is correct: CAT algorithms use previous responses to
tailor difficulty.
B and C are false; items are not random or age-based.
D is irrelevant.
7. Computer Adaptive Testing (CAT)
Which situation will cause the CAT algorithm to end the exam?
A. 75 consecutive correct answers
B. Reaching the 145-question maximum without meeting
, pass/fail confidence
C. A score estimate above or below passing standard with 95%
confidence
D. Answering all questions designated as priority client needs
Correct Answer: C
Rationale:
C is correct: the exam stops when the pass/fail decision
meets the 95% confidence criterion.
A is not a CAT rule.
B is incorrect; exam ends at maximum questions
regardless of confidence.
D does not apply.
8. Computer Adaptive Testing (CAT)
A candidate answers the first dozen questions correctly. The
next item is unexpectedly very difficult. The most appropriate
interpretation is:
A. The algorithm is adjusting to determine the candidate’s
ability
B. The candidate performed poorly on content review
C. The test bank is malfunctioning
D. The candidate’s time management is ineffective
Correct Answer: A
Rationale:
Saunders: Chapter-Based MCQs and
Rationales
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. Pyramid to Success
A newly graduated nurse recalls the “Pyramid to Success” for
NCLEX preparation. Which foundational element does the base
of the pyramid represent?
A. Test-taking strategies
B. Content mastery
C. Critical thinking
D. Time management
Correct Answer: C
Rationale:
C is correct because critical thinking skills form the base,
allowing synthesis of content and application on exam
items.
A is incorrect; test-taking strategies are higher in the
pyramid.
B is content mastery, which sits above critical thinking.
D time management is a strategy, not foundational.
2. Pyramid to Success
Which statement best explains why test-taking strategies are
placed near the top of the Pyramid to Success?
A. They are the most difficult skills to teach.
B. They rely on mastery of content and critical thinking.
,C. They are useful only on exam day.
D. They replace the need for content review.
Correct Answer: B
Rationale:
B is correct: strategies build on content knowledge and
critical thinking.
A is incorrect; difficulty isn’t the criterion.
C is false: strategies are applied during study and on exam
day.
D is incorrect; strategies complement, not replace, content
review.
3. Examination Process
A candidate is completing the NCLEX application. Which action
most directly affects eligibility to sit for the exam?
A. Selecting a convenient test center
B. Submitting official transcripts to the regulatory body
C. Reviewing the NCLEX Test Plan
D. Purchasing NCLEX review materials
Correct Answer: B
Rationale:
B is correct: transcripts verify educational requirements,
determining eligibility.
A is scheduling, not eligibility.
, C and D are preparatory but don’t affect eligibility.
4. Examination Process
On test day, the candidate experiences computer issues.
According to testing policy, what should the candidate do first?
A. Restart the computer and continue testing
B. Notify the test administrator immediately
C. Wait for the system to auto-recover
D. Contact Pearson VUE customer service after leaving
Correct Answer: B
Rationale:
B is correct: the test administrator must be notified for
official troubleshooting.
A could lose exam progress.
C wastes time and may violate procedures.
D delays resolution; must be handled onsite.
5. Examination Process
After completing the NCLEX, how soon will unofficial results be
available?
A. Immediately on screen
B. Within 48 hours online
C. In 4–6 weeks by mail
D. After the candidate scores the minimum items
,Correct Answer: A
Rationale:
A is correct: CAT provides a pass/fail screen immediately.
B and C refer to official reports, not the screen result.
D misstates the process.
6. Computer Adaptive Testing (CAT)
In NCLEX CAT, the difficulty of each new question is determined
by:
A. The candidate’s previous answered items
B. Random selection within the test plan
C. Item age in the bank
D. The candidate’s test center location
Correct Answer: A
Rationale:
A is correct: CAT algorithms use previous responses to
tailor difficulty.
B and C are false; items are not random or age-based.
D is irrelevant.
7. Computer Adaptive Testing (CAT)
Which situation will cause the CAT algorithm to end the exam?
A. 75 consecutive correct answers
B. Reaching the 145-question maximum without meeting
, pass/fail confidence
C. A score estimate above or below passing standard with 95%
confidence
D. Answering all questions designated as priority client needs
Correct Answer: C
Rationale:
C is correct: the exam stops when the pass/fail decision
meets the 95% confidence criterion.
A is not a CAT rule.
B is incorrect; exam ends at maximum questions
regardless of confidence.
D does not apply.
8. Computer Adaptive Testing (CAT)
A candidate answers the first dozen questions correctly. The
next item is unexpectedly very difficult. The most appropriate
interpretation is:
A. The algorithm is adjusting to determine the candidate’s
ability
B. The candidate performed poorly on content review
C. The test bank is malfunctioning
D. The candidate’s time management is ineffective
Correct Answer: A
Rationale:
