, SmartPrep NCLEX-RN® by Saunders:
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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. A nurse recalls that the Pyramid to Success emphasizes
foundational skills. Which tier of the pyramid is the base on
which all other clinical judgment abilities rest?
A. Reflection
B. Experience
C. Knowledge
D. Contextual Awareness
Correct Answer: C
Rationale: Knowledge (basic scientific and clinical information)
is the foundation of the Pyramid to Success; without solid
knowledge, higher-order clinical judgment cannot develop.
Reflection and experience build on knowledge, and contextual
awareness is a higher-level skill influenced by both knowledge
and experience.
2. During NCLEX preparation, a student reviews the
Examination Process. Which activity accurately describes
‘practice effect’?
A. Improved performance due to repeated use of the same
strategy
B. Increased anxiety after multiple practice exams
C. Enhanced memory from varied question formats
D. Improved test-taking speed from familiarity with the
computer interface
Correct Answer: A
Rationale: Practice effect refers to performance improvements
,when the same strategy/question type is repeated, leading to
familiarity. Options C and D describe benefits of varied practice
and interface familiarity but are not the definition of practice
effect. Option B is incorrect as it describes a negative outcome.
3. A student nurse taking a CAT practice exam notices the
computer stops after 75 questions. What does this indicate?
A. The item pool is exhausted
B. The student’s competence level is definitively established
C. The minimum and maximum question constraints were
reached
D. The student failed to answer quickly enough
Correct Answer: C
Rationale: CAT uses minimum and maximum question limits; if
the test terminates at 75, it reached one of those bounds
(commonly 75 max). An exhausted item pool (A) is rare;
competence isn’t “definitively” judged (B) at that point, and
time to answer (D) doesn’t terminate CAT.
4. Which statement about the NCLEX-RN Test Plan is correct?
A. It is updated every 10 years
B. It outlines detailed content areas and relative weights
C. It prescribes an exact number of questions per topic
D. It is identical for LPN and RN examinations
,Correct Answer: B
Rationale: The NCLEX-RN Test Plan specifies content domains
and their percentage weights. It’s reviewed every three years
(not A), does not fix exact question counts (C), and differs from
the LPN test plan (D).
5. A faculty member explains that in Computer Adaptive
Testing, difficulty adjusts based on responses. If a candidate
answers correctly, the next item is:
A. Slightly easier
B. Slightly harder
C. The same difficulty
D. Randomly chosen
Correct Answer: B
Rationale: In CAT, a correct answer yields a slightly harder next
question to refine the estimate of ability. Incorrect answers
lead to easier items; same difficulty (C) or random selection (D)
do not apply.
6. According to the Pyramid to Success, which skill is at the
apex?
A. Pattern Recognition
B. Clinical Judgment
C. Reflection
D. Experience
,Correct Answer: C
Rationale: Reflection (critical evaluation of one’s own
decisions) sits at the apex, integrating all other components.
Clinical judgment is the overall goal, not a tier; pattern
recognition and experience lie in middle tiers.
7. Which phase of the Examination Process involves reviewing
content areas and allocating study time accordingly?
A. Planning
B. Implementation
C. Evaluation
D. Reflection
Correct Answer: A
Rationale: Planning includes identifying what to study and
creating schedules. Implementation is carrying out the plan;
evaluation checks progress, and reflection evaluates strategies
afterward.
8. Which characteristic is unique to Computer Adaptive
Testing?
A. Fixed time limit
B. Random ordering of questions
C. Real-time scoring
D. Adaptive difficulty
, Correct Answer: D
Rationale: Adaptive difficulty is central to CAT, tailoring each
item to ability level. While CAT has time limits, they’re not
unique (A). Random ordering (B) and scoring after test
completion (not real-time; C) aren’t defining features.
9. The NCLEX-RN Test Plan is divided into four major categories.
Which one is not among them?
A. Safe and Effective Care Environment
B. Pharmacological and Parenteral Therapies
C. Physiological Adaptation
D. Psychosocial Integrity
Correct Answer: B
Rationale: ‘Pharmacological and Parenteral Therapies’ is a
subcategory under Physiological Integrity, not a major category.
Safe and Effective Care Environment, Physiological Adaptation
(incorrect name—should be Physiological Integrity), and
Psychosocial Integrity are correct domains.
10. During a practice CAT, the nurse notes test termination at
the minimum number of questions. What does this suggest?
A. Candidate answered too slowly
B. Competence was clearly demonstrated early
C. There was an error in the CAT algorithm
D. The item pool ran out
Complete Chapter Q&A with Instant
Feedback
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. A nurse recalls that the Pyramid to Success emphasizes
foundational skills. Which tier of the pyramid is the base on
which all other clinical judgment abilities rest?
A. Reflection
B. Experience
C. Knowledge
D. Contextual Awareness
Correct Answer: C
Rationale: Knowledge (basic scientific and clinical information)
is the foundation of the Pyramid to Success; without solid
knowledge, higher-order clinical judgment cannot develop.
Reflection and experience build on knowledge, and contextual
awareness is a higher-level skill influenced by both knowledge
and experience.
2. During NCLEX preparation, a student reviews the
Examination Process. Which activity accurately describes
‘practice effect’?
A. Improved performance due to repeated use of the same
strategy
B. Increased anxiety after multiple practice exams
C. Enhanced memory from varied question formats
D. Improved test-taking speed from familiarity with the
computer interface
Correct Answer: A
Rationale: Practice effect refers to performance improvements
,when the same strategy/question type is repeated, leading to
familiarity. Options C and D describe benefits of varied practice
and interface familiarity but are not the definition of practice
effect. Option B is incorrect as it describes a negative outcome.
3. A student nurse taking a CAT practice exam notices the
computer stops after 75 questions. What does this indicate?
A. The item pool is exhausted
B. The student’s competence level is definitively established
C. The minimum and maximum question constraints were
reached
D. The student failed to answer quickly enough
Correct Answer: C
Rationale: CAT uses minimum and maximum question limits; if
the test terminates at 75, it reached one of those bounds
(commonly 75 max). An exhausted item pool (A) is rare;
competence isn’t “definitively” judged (B) at that point, and
time to answer (D) doesn’t terminate CAT.
4. Which statement about the NCLEX-RN Test Plan is correct?
A. It is updated every 10 years
B. It outlines detailed content areas and relative weights
C. It prescribes an exact number of questions per topic
D. It is identical for LPN and RN examinations
,Correct Answer: B
Rationale: The NCLEX-RN Test Plan specifies content domains
and their percentage weights. It’s reviewed every three years
(not A), does not fix exact question counts (C), and differs from
the LPN test plan (D).
5. A faculty member explains that in Computer Adaptive
Testing, difficulty adjusts based on responses. If a candidate
answers correctly, the next item is:
A. Slightly easier
B. Slightly harder
C. The same difficulty
D. Randomly chosen
Correct Answer: B
Rationale: In CAT, a correct answer yields a slightly harder next
question to refine the estimate of ability. Incorrect answers
lead to easier items; same difficulty (C) or random selection (D)
do not apply.
6. According to the Pyramid to Success, which skill is at the
apex?
A. Pattern Recognition
B. Clinical Judgment
C. Reflection
D. Experience
,Correct Answer: C
Rationale: Reflection (critical evaluation of one’s own
decisions) sits at the apex, integrating all other components.
Clinical judgment is the overall goal, not a tier; pattern
recognition and experience lie in middle tiers.
7. Which phase of the Examination Process involves reviewing
content areas and allocating study time accordingly?
A. Planning
B. Implementation
C. Evaluation
D. Reflection
Correct Answer: A
Rationale: Planning includes identifying what to study and
creating schedules. Implementation is carrying out the plan;
evaluation checks progress, and reflection evaluates strategies
afterward.
8. Which characteristic is unique to Computer Adaptive
Testing?
A. Fixed time limit
B. Random ordering of questions
C. Real-time scoring
D. Adaptive difficulty
, Correct Answer: D
Rationale: Adaptive difficulty is central to CAT, tailoring each
item to ability level. While CAT has time limits, they’re not
unique (A). Random ordering (B) and scoring after test
completion (not real-time; C) aren’t defining features.
9. The NCLEX-RN Test Plan is divided into four major categories.
Which one is not among them?
A. Safe and Effective Care Environment
B. Pharmacological and Parenteral Therapies
C. Physiological Adaptation
D. Psychosocial Integrity
Correct Answer: B
Rationale: ‘Pharmacological and Parenteral Therapies’ is a
subcategory under Physiological Integrity, not a major category.
Safe and Effective Care Environment, Physiological Adaptation
(incorrect name—should be Physiological Integrity), and
Psychosocial Integrity are correct domains.
10. During a practice CAT, the nurse notes test termination at
the minimum number of questions. What does this suggest?
A. Candidate answered too slowly
B. Competence was clearly demonstrated early
C. There was an error in the CAT algorithm
D. The item pool ran out
