LIPPINCOTT Q&A REVIEW FOR
NCLEX-RN
14TH EDITION
• AUTHOR(S)DIANE BILLINGS;
DESIREE HENSEL
TEST BANK
1
Reference: Ch. 1 — The NCLEX-RN® Licensing Examination —
Computer Adaptive Testing (CAT) & Test Administration
Stem: A candidate is halfway through the NCLEX and notices
the computer repeatedly presents questions of similar difficulty
despite answering several correctly. The candidate becomes
anxious and thinks the test is unfair. What is the nurse
educator’s best explanation to reduce the candidate’s anxiety?
A. “The test must be malfunctioning — you should stop and
report it to the proctor.”
,B. “CAT presents items to estimate your ability level; similar
difficulty items are normal while the algorithm narrows your
standing.”
C. “Because you answered correctly, the system will
immediately stop and issue a pass.”
D. “These items are a form of security check — ignore them and
continue.”
Correct Answer: B
Rationale — Correct: The CAT algorithm adapts to the
candidate’s performance by selecting items that best estimate
ability; receiving similarly difficult items while the algorithm
refines the score is expected. Explaining CAT reduces anxiety
and helps the candidate focus on answering each item rather
than on perceived unfairness. This aligns with test
administration and the candidate’s right to procedural
understanding.
Rationale — Incorrect:
A. Prematurely reporting a malfunction without evidence may
interrupt testing; proctors should be informed only for clear
technical failure.
C. Tests do not stop immediately after a few correct answers;
stopping criteria are statistical and not instantaneous.
D. There is no standard “security check” of items in this
manner; presenting similar items is a function of adaptive
testing, not an ad hoc security measure.
,Teaching point: CAT adapts to estimate ability; similar-difficulty
items are expected during measurement refinement.
Citation: Billings, D. M., & Hensel, D. (2024). Lippincott Q&A
Review for NCLEX-RN (14th ed.). Wolters Kluwer. Ch. 1.
2
Reference: Ch. 1 — Exam Security & Confidentiality — Test
Center Conduct
Stem: A candidate arrives at the test center and is asked to
leave their smartwatch and phone in a locker. The candidate
asks the proctor whether they may keep their smartwatch on
but powered off because it contains important medical alerts.
What is the most appropriate action by the test center staff or
educator?
A. Allow the candidate to keep the powered-off smartwatch at
the testing station.
B. Permit the smartwatch in the locker and advise the candidate
to contact family for medical alerts.
C. Ask the candidate to wear the device and ensure it is muted
with notifications disabled.
D. Provide information on acceptable alternatives and follow
established security policies for devices.
Correct Answer: D
Rationale — Correct: Test centers have established security
policies that must be followed; staff should explain acceptable
, alternatives (e.g., locking the device in a secure locker) and
follow procedure while being sensitive to health concerns.
Providing clear information and following policy balances
security with candidate needs and reduces confusion or
possible confidentiality breaches.
Rationale — Incorrect:
A. Allowing the device at the testing station violates typical
security policies and risks exam integrity.
B. Simply placing it in the locker without addressing the
candidate’s medical concern is dismissive; alternatives and
policies should be explained.
C. Allowing the device worn during testing, even muted,
typically breaches security rules.
Teaching point: Explain test-center device policies and offer
approved alternatives when candidates report health concerns.
Citation: Billings & Hensel (2024). Ch. 1.
3
Reference: Ch. 1 — Special Accommodations — Exam
Administration
Stem: A candidate with a documented visual impairment
requests extra time and a reader for the NCLEX. Which step is
the most appropriate immediate action by the candidate’s
nurse educator or program coordinator to best protect the
student’s testing rights?
NCLEX-RN
14TH EDITION
• AUTHOR(S)DIANE BILLINGS;
DESIREE HENSEL
TEST BANK
1
Reference: Ch. 1 — The NCLEX-RN® Licensing Examination —
Computer Adaptive Testing (CAT) & Test Administration
Stem: A candidate is halfway through the NCLEX and notices
the computer repeatedly presents questions of similar difficulty
despite answering several correctly. The candidate becomes
anxious and thinks the test is unfair. What is the nurse
educator’s best explanation to reduce the candidate’s anxiety?
A. “The test must be malfunctioning — you should stop and
report it to the proctor.”
,B. “CAT presents items to estimate your ability level; similar
difficulty items are normal while the algorithm narrows your
standing.”
C. “Because you answered correctly, the system will
immediately stop and issue a pass.”
D. “These items are a form of security check — ignore them and
continue.”
Correct Answer: B
Rationale — Correct: The CAT algorithm adapts to the
candidate’s performance by selecting items that best estimate
ability; receiving similarly difficult items while the algorithm
refines the score is expected. Explaining CAT reduces anxiety
and helps the candidate focus on answering each item rather
than on perceived unfairness. This aligns with test
administration and the candidate’s right to procedural
understanding.
Rationale — Incorrect:
A. Prematurely reporting a malfunction without evidence may
interrupt testing; proctors should be informed only for clear
technical failure.
C. Tests do not stop immediately after a few correct answers;
stopping criteria are statistical and not instantaneous.
D. There is no standard “security check” of items in this
manner; presenting similar items is a function of adaptive
testing, not an ad hoc security measure.
,Teaching point: CAT adapts to estimate ability; similar-difficulty
items are expected during measurement refinement.
Citation: Billings, D. M., & Hensel, D. (2024). Lippincott Q&A
Review for NCLEX-RN (14th ed.). Wolters Kluwer. Ch. 1.
2
Reference: Ch. 1 — Exam Security & Confidentiality — Test
Center Conduct
Stem: A candidate arrives at the test center and is asked to
leave their smartwatch and phone in a locker. The candidate
asks the proctor whether they may keep their smartwatch on
but powered off because it contains important medical alerts.
What is the most appropriate action by the test center staff or
educator?
A. Allow the candidate to keep the powered-off smartwatch at
the testing station.
B. Permit the smartwatch in the locker and advise the candidate
to contact family for medical alerts.
C. Ask the candidate to wear the device and ensure it is muted
with notifications disabled.
D. Provide information on acceptable alternatives and follow
established security policies for devices.
Correct Answer: D
Rationale — Correct: Test centers have established security
policies that must be followed; staff should explain acceptable
, alternatives (e.g., locking the device in a secure locker) and
follow procedure while being sensitive to health concerns.
Providing clear information and following policy balances
security with candidate needs and reduces confusion or
possible confidentiality breaches.
Rationale — Incorrect:
A. Allowing the device at the testing station violates typical
security policies and risks exam integrity.
B. Simply placing it in the locker without addressing the
candidate’s medical concern is dismissive; alternatives and
policies should be explained.
C. Allowing the device worn during testing, even muted,
typically breaches security rules.
Teaching point: Explain test-center device policies and offer
approved alternatives when candidates report health concerns.
Citation: Billings & Hensel (2024). Ch. 1.
3
Reference: Ch. 1 — Special Accommodations — Exam
Administration
Stem: A candidate with a documented visual impairment
requests extra time and a reader for the NCLEX. Which step is
the most appropriate immediate action by the candidate’s
nurse educator or program coordinator to best protect the
student’s testing rights?
