SAUNDERS COMPREHENSIVE REVIEW
FOR THE NCLEX-PN® EXAMINATION
9TH EDITION
• AUTHOR(S)LINDA ANNE SILVESTRI;
ANGELA SILVESTRI
TEST BANK
1
Reference: Ch. 1 — Clinical Judgment and Next Generation
NCLEX® Items — Pyramid to Success
Stem: As a PN educator preparing students for NGN items,
which classroom activity best develops the Pyramid to Success
skill of “recognizing cues”?
A. Posting a long list of facts for students to memorize before
exam review.
B. Having students analyze a short case and identify three
relevant patient cues.
C. Giving students a timed multiple-choice quiz of unrelated
items.
,D. Asking students to write an essay summarizing a textbook
chapter.
Correct Answer: B
Rationales
• Correct (B): Analyzing a short case and identifying relevant
cues trains students to detect salient clinical information,
directly aligning with the Pyramid to Success step
“recognizing cues.” This is an application task appropriate
for PN preparation.
• A (incorrect): Memorization of facts does not train
students to detect or prioritize patient cues; it emphasizes
recall rather than clinical judgment.
• C (incorrect): Timed unrelated MCQs may build test
stamina but do not focus students on cue recognition or
clinical pattern recognition.
• D (incorrect): Writing a chapter summary practices
synthesis and recall but is less effective for rapid cue
detection needed in NGN items.
Teaching Point: Practice case cue identification to strengthen
clinical judgment and NGN readiness.
Citation: Silvestri, L. A., & Silvestri, A. (2025). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Ch. 1.
,2
Reference: Ch. 1 — NGN Test Design — Clinical Judgment
Measurement Model (CJMM)
Stem: During a NGN case-based item, a candidate must choose
the most appropriate nursing action after identifying two
abnormal cues. According to CJMM principles, what should the
PN prioritize when selecting the action?
A. Choose the action that is most complex to demonstrate
higher-level thinking.
B. Select the immediate intervention that prevents harm based
on the recognized cues.
C. Pick an action that documents the findings and defers
intervention to the RN.
D. Select the least invasive action to avoid responsibility for
complications.
Correct Answer: B
Rationales
• Correct (B): CJMM emphasizes prioritizing actions that
address immediate safety risks; selecting the intervention
that prevents harm aligns with PN scope and clinical
judgment.
• A (incorrect): Complexity alone does not indicate
appropriateness; the correct action must match the clinical
priority and safety needs.
, • C (incorrect): Documentation is important but should not
replace immediate, nurse-initiated safety interventions
when within PN scope.
• D (incorrect): Avoiding responsibility by choosing minimal
action can delay necessary care and compromise safety.
Teaching Point: In NGN items prioritize immediate, safety-
focused interventions aligned with PN scope.
Citation: Silvestri, L. A., & Silvestri, A. (2025). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Ch. 1.
3
Reference: Ch. 1 — Types of Questions on the Examination and
Scoring — NGN Item Formats
Stem: A PN candidate practices for NGN and wants to
understand item types. Which student activity best simulates
the NGN clinical scenario format?
A. Completing single-concept recall flashcards.
B. Working through a branched case that requires sequential
decisions.
C. Taking a true/false quiz on medication side effects.
D. Memorizing definitions of clinical terms.
Correct Answer: B
Rationales
FOR THE NCLEX-PN® EXAMINATION
9TH EDITION
• AUTHOR(S)LINDA ANNE SILVESTRI;
ANGELA SILVESTRI
TEST BANK
1
Reference: Ch. 1 — Clinical Judgment and Next Generation
NCLEX® Items — Pyramid to Success
Stem: As a PN educator preparing students for NGN items,
which classroom activity best develops the Pyramid to Success
skill of “recognizing cues”?
A. Posting a long list of facts for students to memorize before
exam review.
B. Having students analyze a short case and identify three
relevant patient cues.
C. Giving students a timed multiple-choice quiz of unrelated
items.
,D. Asking students to write an essay summarizing a textbook
chapter.
Correct Answer: B
Rationales
• Correct (B): Analyzing a short case and identifying relevant
cues trains students to detect salient clinical information,
directly aligning with the Pyramid to Success step
“recognizing cues.” This is an application task appropriate
for PN preparation.
• A (incorrect): Memorization of facts does not train
students to detect or prioritize patient cues; it emphasizes
recall rather than clinical judgment.
• C (incorrect): Timed unrelated MCQs may build test
stamina but do not focus students on cue recognition or
clinical pattern recognition.
• D (incorrect): Writing a chapter summary practices
synthesis and recall but is less effective for rapid cue
detection needed in NGN items.
Teaching Point: Practice case cue identification to strengthen
clinical judgment and NGN readiness.
Citation: Silvestri, L. A., & Silvestri, A. (2025). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Ch. 1.
,2
Reference: Ch. 1 — NGN Test Design — Clinical Judgment
Measurement Model (CJMM)
Stem: During a NGN case-based item, a candidate must choose
the most appropriate nursing action after identifying two
abnormal cues. According to CJMM principles, what should the
PN prioritize when selecting the action?
A. Choose the action that is most complex to demonstrate
higher-level thinking.
B. Select the immediate intervention that prevents harm based
on the recognized cues.
C. Pick an action that documents the findings and defers
intervention to the RN.
D. Select the least invasive action to avoid responsibility for
complications.
Correct Answer: B
Rationales
• Correct (B): CJMM emphasizes prioritizing actions that
address immediate safety risks; selecting the intervention
that prevents harm aligns with PN scope and clinical
judgment.
• A (incorrect): Complexity alone does not indicate
appropriateness; the correct action must match the clinical
priority and safety needs.
, • C (incorrect): Documentation is important but should not
replace immediate, nurse-initiated safety interventions
when within PN scope.
• D (incorrect): Avoiding responsibility by choosing minimal
action can delay necessary care and compromise safety.
Teaching Point: In NGN items prioritize immediate, safety-
focused interventions aligned with PN scope.
Citation: Silvestri, L. A., & Silvestri, A. (2025). Saunders
Comprehensive Review for the NCLEX-PN® Examination (9th
ed.). Ch. 1.
3
Reference: Ch. 1 — Types of Questions on the Examination and
Scoring — NGN Item Formats
Stem: A PN candidate practices for NGN and wants to
understand item types. Which student activity best simulates
the NGN clinical scenario format?
A. Completing single-concept recall flashcards.
B. Working through a branched case that requires sequential
decisions.
C. Taking a true/false quiz on medication side effects.
D. Memorizing definitions of clinical terms.
Correct Answer: B
Rationales
