,Master Every NCLEX-RN® Chapter:
Saunders Q&A Format with Real
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).
Pyramid to Success (Questions 1–7)
1. A new graduate nurse is reviewing the Pyramid to Success as
they prepare for the NCLEX-RN®. Which level of the pyramid
emphasizes integrating knowledge, clinical reasoning, and
decision-making to deliver safe patient care?
A. Foundational Knowledge
B. Clinical Judgment ★
C. Test-taking Strategies
D. Content Review
Answer: B. Clinical Judgment
Rationale:
B. Clinical Judgment is the apex of the Pyramid, reflecting
the integration of knowledge and decision-making to
ensure safe care.
A. Foundational Knowledge is the base layer—essential
facts and concepts.
C. Test-taking Strategies support exam performance but
do not encompass clinical reasoning.
D. Content Review is the intermediate layer focusing on
memorization and understanding of topics.
,2. Which component of the Pyramid to Success focuses on
familiarizing the candidate with NCLEX-style question formats
and the CAT environment?
A. Content Review
B. Clinical Judgment
C. Test-taking Strategies ★
D. Applied Practice
Answer: C. Test-taking Strategies
Rationale:
C. Test-taking Strategies include understanding item
types, pacing, and how to navigate CAT.
A. Content Review centers on topic mastery.
B. Clinical Judgment applies knowledge in practice
scenarios.
D. Applied Practice refers to completing practice
questions and analyzing rationales.
3. A student places equal emphasis on memorizing facts and
practicing NCLEX-style items. Which layer of the pyramid are
they at?
A. Foundational Knowledge
B. Content Review ★
C. Applied Practice
D. Clinical Judgment
,Answer: B. Content Review
Rationale:
B. Content Review involves memorization and
comprehension of facts.
A. Foundational Knowledge is simply acquiring facts.
C. Applied Practice is using questions to deepen
understanding.
D. Clinical Judgment is advanced application in patient
scenarios.
4. During a study session, a candidate uses flashcards to learn
normal lab values. This activity best represents which level of
the pyramid?
A. Clinical Judgment
B. Test-taking Strategies
C. Foundational Knowledge ★
D. Content Review
Answer: C. Foundational Knowledge
Rationale:
C. Foundational Knowledge is acquiring basic facts (e.g.,
lab values).
D. Content Review would involve understanding clinical
implications of abnormal values.
, A. Clinical Judgment uses that knowledge in context.
B. Test-taking Strategies focus on exam technique, not
fact memorization.
5. Which action best demonstrates “Applied Practice” in the
Pyramid to Success?
A. Writing summaries of pathophysiology chapters
B. Completing NCLEX-style questions and reviewing rationales
★
C. Attending a lecture on exam format
D. Memorizing priority-setting frameworks
Answer: B. Completing NCLEX-style questions and reviewing
rationales
Rationale:
B. Applied Practice is active engagement—answering
questions, analyzing both correct and incorrect responses.
A. Writing summaries is content review.
C. Attending format lecture is test-taking strategies.
D. Memorizing frameworks may support clinical judgment
but is more content-oriented.
6. A candidate realizes that despite strong content knowledge,
she struggles with locating the next adaptive question on the
, screen. Which pyramid layer should she focus on
strengthening?
A. Foundational Knowledge
B. Test-taking Strategies ★
C. Applied Practice
D. Clinical Judgment
Answer: B. Test-taking Strategies
Rationale:
Difficulty navigating the CAT interface is a test-taking
strategy issue.
Foundational Knowledge and Clinical Judgment are
content and reasoning layers, respectively.
Applied Practice might help but the core issue is strategic
familiarity.
7. Integrating all pyramid levels culminates in which key NCLEX
success outcome?
A. Memorization of test blueprint
B. Efficient test navigation
C. Safe, effective clinical decision-making ★
D. Completion of all practice questions
Answer: C. Safe, effective clinical decision-making
Rationale:
Saunders Q&A Format with Real
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).
Pyramid to Success (Questions 1–7)
1. A new graduate nurse is reviewing the Pyramid to Success as
they prepare for the NCLEX-RN®. Which level of the pyramid
emphasizes integrating knowledge, clinical reasoning, and
decision-making to deliver safe patient care?
A. Foundational Knowledge
B. Clinical Judgment ★
C. Test-taking Strategies
D. Content Review
Answer: B. Clinical Judgment
Rationale:
B. Clinical Judgment is the apex of the Pyramid, reflecting
the integration of knowledge and decision-making to
ensure safe care.
A. Foundational Knowledge is the base layer—essential
facts and concepts.
C. Test-taking Strategies support exam performance but
do not encompass clinical reasoning.
D. Content Review is the intermediate layer focusing on
memorization and understanding of topics.
,2. Which component of the Pyramid to Success focuses on
familiarizing the candidate with NCLEX-style question formats
and the CAT environment?
A. Content Review
B. Clinical Judgment
C. Test-taking Strategies ★
D. Applied Practice
Answer: C. Test-taking Strategies
Rationale:
C. Test-taking Strategies include understanding item
types, pacing, and how to navigate CAT.
A. Content Review centers on topic mastery.
B. Clinical Judgment applies knowledge in practice
scenarios.
D. Applied Practice refers to completing practice
questions and analyzing rationales.
3. A student places equal emphasis on memorizing facts and
practicing NCLEX-style items. Which layer of the pyramid are
they at?
A. Foundational Knowledge
B. Content Review ★
C. Applied Practice
D. Clinical Judgment
,Answer: B. Content Review
Rationale:
B. Content Review involves memorization and
comprehension of facts.
A. Foundational Knowledge is simply acquiring facts.
C. Applied Practice is using questions to deepen
understanding.
D. Clinical Judgment is advanced application in patient
scenarios.
4. During a study session, a candidate uses flashcards to learn
normal lab values. This activity best represents which level of
the pyramid?
A. Clinical Judgment
B. Test-taking Strategies
C. Foundational Knowledge ★
D. Content Review
Answer: C. Foundational Knowledge
Rationale:
C. Foundational Knowledge is acquiring basic facts (e.g.,
lab values).
D. Content Review would involve understanding clinical
implications of abnormal values.
, A. Clinical Judgment uses that knowledge in context.
B. Test-taking Strategies focus on exam technique, not
fact memorization.
5. Which action best demonstrates “Applied Practice” in the
Pyramid to Success?
A. Writing summaries of pathophysiology chapters
B. Completing NCLEX-style questions and reviewing rationales
★
C. Attending a lecture on exam format
D. Memorizing priority-setting frameworks
Answer: B. Completing NCLEX-style questions and reviewing
rationales
Rationale:
B. Applied Practice is active engagement—answering
questions, analyzing both correct and incorrect responses.
A. Writing summaries is content review.
C. Attending format lecture is test-taking strategies.
D. Memorizing frameworks may support clinical judgment
but is more content-oriented.
6. A candidate realizes that despite strong content knowledge,
she struggles with locating the next adaptive question on the
, screen. Which pyramid layer should she focus on
strengthening?
A. Foundational Knowledge
B. Test-taking Strategies ★
C. Applied Practice
D. Clinical Judgment
Answer: B. Test-taking Strategies
Rationale:
Difficulty navigating the CAT interface is a test-taking
strategy issue.
Foundational Knowledge and Clinical Judgment are
content and reasoning layers, respectively.
Applied Practice might help but the core issue is strategic
familiarity.
7. Integrating all pyramid levels culminates in which key NCLEX
success outcome?
A. Memorization of test blueprint
B. Efficient test navigation
C. Safe, effective clinical decision-making ★
D. Completion of all practice questions
Answer: C. Safe, effective clinical decision-making
Rationale:
