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: The Pyramid to Success
A nursing graduate has six weeks remaining before the NCLEX-RN
examination. The graduate plans to study for 12 hours daily during the final
three days but has not established a study schedule. Which action would
best support a more effective preparation strategy?
A. Focus primarily on memorizing answers to previously encountered
practice questions.
B. Develop a consistent study plan that combines content review, practice
questions, rationales, and regular progress evaluation.
C. Delay practice examinations until all nursing content has been
reviewed.
D. Concentrate on the subjects the graduate enjoys most to maintain
motivation.
Correct Answer: B. Develop a consistent study plan that combines content
review, practice questions, rationales, and regular progress evaluation.
1
,Rationale: Successful preparation involves consistent study habits,
identification of knowledge gaps, application of nursing concepts, and
evaluation of progress. Reviewing rationales for both correct and incorrect
answers helps learners understand clinical reasoning rather than
memorize isolated answers. A structured plan also distributes learning
over time instead of relying on last-minute cramming.
Distractor Rationales:
• A. Incorrect: Memorization alone does not adequately prepare
candidates to interpret unfamiliar scenarios or apply nursing
principles.
• C. Incorrect: Practice questions can identify weaknesses early and
guide subsequent content review.
• D. Incorrect: Avoiding challenging subjects leaves important
knowledge gaps unaddressed.
Key Teaching Point: Effective exam preparation combines structured
review, active practice, rationale analysis, and ongoing self-assessment.
Cognitive Level: Application · Client Needs: Management of Care · Nursing
Process: Planning · Clinical Judgment: Generate Solutions
Question 2: The NCLEX-RN Examination Process
A candidate has graduated from an approved nursing program and
completed the examination registration process. The candidate assumes
that paying the examination fee means the candidate is automatically
eligible to test. Which information should the candidate understand?
A. Graduation and payment automatically authorize the candidate to
schedule an examination.
B. Pearson VUE independently grants nursing licenses after candidates
complete registration.
2
,C. The examination is optional if the nursing program confirms that the
graduate has passed all courses.
D. The nursing regulatory body must determine eligibility, and the
candidate generally needs an Authorization to Test (ATT) before
scheduling.
Correct Answer: D. The nursing regulatory body must determine eligibility,
and the candidate generally needs an Authorization to Test (ATT) before
scheduling.
Rationale: NCLEX registration and licensure eligibility are related but
distinct processes. The candidate registers for the examination and applies
through the relevant nursing regulatory body, which determines eligibility
according to its requirements. After eligibility is confirmed, the candidate
receives an ATT and can schedule the examination within the authorization
period.
Distractor Rationales:
• A. Incorrect: Graduation and payment do not independently
establish regulatory eligibility or provide an ATT.
• B. Incorrect: Pearson VUE administers the examination; nursing
regulatory bodies make licensure decisions.
• C. Incorrect: Completing a nursing program does not replace the
required licensure examination when the regulatory body requires it.
Key Teaching Point: Understand the distinction between examination
registration, regulatory eligibility, ATT issuance, examination scheduling,
and licensure.
Cognitive Level: Recall · Client Needs: Management of Care · Nursing
Process: Planning · Clinical Judgment: Not primarily CJMM-focused
Question 3: Computer Adaptive Testing
3
, A candidate answers several challenging NCLEX-RN questions correctly
and notices that subsequent questions remain difficult. The candidate
becomes concerned that the examination is malfunctioning. Which
response best explains this experience?
A. The computer continually estimates the candidate's ability and selects
subsequent items using the adaptive testing algorithm.
B. The examination is designed to give every candidate the same sequence
of questions regardless of performance.
C. The candidate must answer every question in a section correctly before
receiving a more difficult item.
D. The examination intentionally gives difficult questions to candidates
who have already failed.
Correct Answer: A. The computer continually estimates the candidate's
ability and selects subsequent items using the adaptive testing algorithm.
Rationale: Computer adaptive testing (CAT) updates its estimate of the
candidate's ability as responses are submitted. The next item is selected to
provide useful information about the candidate's ability relative to the
passing standard while maintaining the required content distribution.
Consequently, receiving a difficult question does not indicate failure, just
as receiving an easier question does not establish success.
Distractor Rationales:
• B. Incorrect: CAT does not require every candidate to receive an
identical question sequence.
• C. Incorrect: Item selection is based on the adaptive algorithm, not
perfect performance within a section.
• D. Incorrect: The system does not assign difficult questions as a
punishment or because it has already determined failure.
4
NCLEX-RN® EXAMINATION
8TH EDITION
AUTHOR(S)LINDA SILVESTRI
Unit I: NCLEX-RN® Exam Preparation
Chapter 1: The NCLEX-RN® Examination
Question 1: The Pyramid to Success
A nursing graduate has six weeks remaining before the NCLEX-RN
examination. The graduate plans to study for 12 hours daily during the final
three days but has not established a study schedule. Which action would
best support a more effective preparation strategy?
A. Focus primarily on memorizing answers to previously encountered
practice questions.
B. Develop a consistent study plan that combines content review, practice
questions, rationales, and regular progress evaluation.
C. Delay practice examinations until all nursing content has been
reviewed.
D. Concentrate on the subjects the graduate enjoys most to maintain
motivation.
Correct Answer: B. Develop a consistent study plan that combines content
review, practice questions, rationales, and regular progress evaluation.
1
,Rationale: Successful preparation involves consistent study habits,
identification of knowledge gaps, application of nursing concepts, and
evaluation of progress. Reviewing rationales for both correct and incorrect
answers helps learners understand clinical reasoning rather than
memorize isolated answers. A structured plan also distributes learning
over time instead of relying on last-minute cramming.
Distractor Rationales:
• A. Incorrect: Memorization alone does not adequately prepare
candidates to interpret unfamiliar scenarios or apply nursing
principles.
• C. Incorrect: Practice questions can identify weaknesses early and
guide subsequent content review.
• D. Incorrect: Avoiding challenging subjects leaves important
knowledge gaps unaddressed.
Key Teaching Point: Effective exam preparation combines structured
review, active practice, rationale analysis, and ongoing self-assessment.
Cognitive Level: Application · Client Needs: Management of Care · Nursing
Process: Planning · Clinical Judgment: Generate Solutions
Question 2: The NCLEX-RN Examination Process
A candidate has graduated from an approved nursing program and
completed the examination registration process. The candidate assumes
that paying the examination fee means the candidate is automatically
eligible to test. Which information should the candidate understand?
A. Graduation and payment automatically authorize the candidate to
schedule an examination.
B. Pearson VUE independently grants nursing licenses after candidates
complete registration.
2
,C. The examination is optional if the nursing program confirms that the
graduate has passed all courses.
D. The nursing regulatory body must determine eligibility, and the
candidate generally needs an Authorization to Test (ATT) before
scheduling.
Correct Answer: D. The nursing regulatory body must determine eligibility,
and the candidate generally needs an Authorization to Test (ATT) before
scheduling.
Rationale: NCLEX registration and licensure eligibility are related but
distinct processes. The candidate registers for the examination and applies
through the relevant nursing regulatory body, which determines eligibility
according to its requirements. After eligibility is confirmed, the candidate
receives an ATT and can schedule the examination within the authorization
period.
Distractor Rationales:
• A. Incorrect: Graduation and payment do not independently
establish regulatory eligibility or provide an ATT.
• B. Incorrect: Pearson VUE administers the examination; nursing
regulatory bodies make licensure decisions.
• C. Incorrect: Completing a nursing program does not replace the
required licensure examination when the regulatory body requires it.
Key Teaching Point: Understand the distinction between examination
registration, regulatory eligibility, ATT issuance, examination scheduling,
and licensure.
Cognitive Level: Recall · Client Needs: Management of Care · Nursing
Process: Planning · Clinical Judgment: Not primarily CJMM-focused
Question 3: Computer Adaptive Testing
3
, A candidate answers several challenging NCLEX-RN questions correctly
and notices that subsequent questions remain difficult. The candidate
becomes concerned that the examination is malfunctioning. Which
response best explains this experience?
A. The computer continually estimates the candidate's ability and selects
subsequent items using the adaptive testing algorithm.
B. The examination is designed to give every candidate the same sequence
of questions regardless of performance.
C. The candidate must answer every question in a section correctly before
receiving a more difficult item.
D. The examination intentionally gives difficult questions to candidates
who have already failed.
Correct Answer: A. The computer continually estimates the candidate's
ability and selects subsequent items using the adaptive testing algorithm.
Rationale: Computer adaptive testing (CAT) updates its estimate of the
candidate's ability as responses are submitted. The next item is selected to
provide useful information about the candidate's ability relative to the
passing standard while maintaining the required content distribution.
Consequently, receiving a difficult question does not indicate failure, just
as receiving an easier question does not establish success.
Distractor Rationales:
• B. Incorrect: CAT does not require every candidate to receive an
identical question sequence.
• C. Incorrect: Item selection is based on the adaptive algorithm, not
perfect performance within a section.
• D. Incorrect: The system does not assign difficult questions as a
punishment or because it has already determined failure.
4
