TEXT BOOK ON Strategies for Student Success To the NEXT GENERATION NCLEX(NGN) Test ITEMS-2023 by Linda A.Silvestri and Angela E. Silvestri(2023), NEWEST VERSION AND COMPLETE

is chapter will help yu understand the need fr change in the NCLEX® and the six clinical judgment cgnitive (thinking) skills that serve as the basis fr new test item types n the NGN. Aer a brief review f the current NCLEX® design, thinking skills needed t make safe, evidence-based clinical judgment are intrduced. General NGN Tips are prvided t help yu relate each thinking skill with the new exam. e new NGN item types will be included n the NCLEX® n sner than 2023 and are described in Chapter 2 f this bk. Specic Test-Taking Strategies that will help yu crrectly answer these new items are prvided thrughut ther chapters f this bk and accmpany all practice questins in the bk and n the Evlve site. Be sure t review this chapter before reading the rest f this bk r practicing NGN questins! What Are the Purpose and Design of the Current NCLEX®? As yu knw, prelicensure nursing educatin prgrams like the ne yu’re currently in prepare students fr eligibility t take either the NCLEX-RN® r the NCLEX-PN® aer graduatin. ese natinal licensure examinatins are develped and updated under the directin f the NCSBN. is rganizatin als versees the administratin f the NCLEX® in the United States, Canada, and a number f ther cuntries. e primary purpse f the NCSBN is t protect the public by prviding cmpetency assessments, such as the NCLEX®, that are sund and secure. e NCLEX® is cmprehensive and reects current nursing practice. T ensure examinatin currency, the NCSBN cllects and analyzes nursing practice data every 3 years frm thusands f graduates t determine what knwledge and activities are required in their jbs as new nurses. is infrmatin is used t develp the cntent f the NCLEX® and is rganized in a new licensure test plan every 3 years (.rg/). e test plan is rganized by fur majr Client Needs Categries, sme f which have subcateg ries. In additin, ve Integrated Prcesses are dened and included thrughut the NCLEX® Test Plan as shwn in Bx 1.1 e NCLEX® currently measures the new graduate’s minimum cmpetence in safety t ensure public prtectin thrugh a variety f test items. Mst f the test items (abut 95%) are either Multiple Chice r Multiple Respnse, als knwn as Select All at Apply (SATA) questins. Fr each f these item types, client infrmatin is presented in a shrt clinical scenari fllwed by a questin abut the nurse’s rle in client care. Examples f these test item types are presented in Bx 1.2 As yu’ll ntice in the afrementined test items, each questin fcuses n what the nurse wuld d r say in respnse t specic client data. Only the client infrmatin that is the mst imprtant, relevant, r, in sme cases, f immediate cncern t the nurse is presented in the clinical situatin. e answer is then selected frm a list f chices prvided. e narrw fcus f these test items des nt represent the scpe f actual nursing practice and des nt allw measurement f clinical judgment. Rather, these types f items reect whether the candidate can distinguish between right and wrng. At this pint in yur educatin, yu likely are very familiar with these item types n yur curse exams. Introduction to the Cognitive Skills of Clinical Judgment C H A P T E R 1 THINKING SPACE 2 Strategies for Student Success on the Next Generation NCLEX® (NGN) Test Items Why Is There a Need for NCLEX® Change? Althugh natinal NCLEX® rst-time pass rates fr bth RN and PN graduates have been abve 80% fr many years, health care emplyers cntinue t reprt increasing errrs in client care and lack f apprpriate clinical judgment skills amng new nursing graduates. A recent literature review cnducted by the NCSBN fund that 50% f all nurses have been invlved in at least ne client errr. Sixty percent f thse errrs were the result f pr clinical judgment. Over 80% f nursing emplyers are not satised with the ability f new nursing graduates t make accurate r apprpriate clinical decisi ns regarding client care. In respnse t these data, the NCSBN began t questin if the NCLEX® was measuring “the best thing” t prtect the public. e 2013–2014 Strategic Practice Analysis f activities perfrmed by practicing RNs and RN rle experts cnrmed the imprtance f sund clinical judgment skills fr Integrated Processes Client Needs Categories/Subcategories Nursing Processa Teaching and Learning Communication and Documentation Caring Culture and Spirituality Safe and Eective Care Environment  •Management of Careb  •Safety and Infection Control Health Promotion and Maintenance Psychosocial Integrity Physiological Integrity  •Basic Care and Comfort  •Pharmacological and Parenteral Therapiesc  •Reduction of Risk Potential  •Physiological Adaptation BOX 1.1 NCLEX-RN® Test Plan Organizing Concepts aThis Integrated Process on the NCLEX-PN® Test Plan is the Problem-Solving Process. bThis Client Needs subcategory on the NCLEX-PN® Test Plan is Coordinated Care. cThis Client Needs subcategory on the NCLEX-PN® Test Plan is Pharmacological Therapies. Example : Multiple Choice Single Response The nurse is planning care for a client admitted to the hospital with a diagnosis of acute pancreatitis and controlled hypertension. What is the nurse’s priority for the client’s care at this time? Administer an antiemetic medication. Manage the client’s acute pain. Monitor the client’s blood pressure. Administer supplemental oxygen. Example : Multiple Response (Select All That Apply) The nurse is assessing an adolescent who was taken to the ED for threatening to commit suicide. What is (are) the most appropriate question(s) for the nurse to ask the client at this time? Select all that apply. “What made you want to kill yourself?” “Do you have a plan for killing yourself?” “Do you plan to kill yourself with anyone else?” “Is this the ųrst time you’ve threatened to kill yourself?” “Did you write a suicide note to explain why you are doing this?” BOX 1.2 Examples of Current Multiple Choice and Multiple Response NCLEX® Test Items Note: Indicates correct response(s). THINKING SPACE CHAPTER 1 Introduction to the Cognitive Skills of Clinical Judgment