how to boost your NCLEX score by twenty per cent

NCLEX fever

This blog entry goes out to all those persons who are now studying for NCLEX.  Congratulations on completing your basic nursing education. Why not treat yourself to a great beach read, and buy my book about nursing in Nepal?  the book itself won’t help you with NCLEX but it will get you to think about something else for a while….

NCLEX secrets

I confess that I get annoyed when I see people studying for NCLEX by reviewing page after page of question in some popular NCLEX books. I wonder whether you achieve a greater comprehension of the underlying material that way. I always compare this method to that of doing crossword puzzles. it keeps your mind busy – but will you be a better nurse? the nursing process is not a collection of sound bites or factoids.

your school wants you to succeed

every nursing school keeps track of the first-time test taker pass rates, and there are mechanisms in place to make sure that they are preparing you for what you will need to know. One question that students do not often ask is, how does NCLEX decide what to put on the exam in the first place?  the answer: NCSBN tells them.

Alphabet soup NCLEX and NCSBN

NCSBN is the National Council of State Boards of Nursing, and if you go to their website, you can read the test blueprint for the NCLEX exam. NCSBN periodically surveys nurses, schools and hospitals around the country, to gather info as to what “any prudent nurse” might be expected to know, and uses this to adjust exam content accordingly.

A 65% pass rate is also a 35% fail rate

A few years back I taught at a school of nursing that was deeply concerned about the pass rate of the class they had just graduated. When a student does not do well on the exam, their focus is on what they did; but from a school perspective,  nobody wants to get calls from angry parents, the Board of Nursing,  or the college’s Board of Governors about the pass rate. When this group of seniors did so poorly it led the school to organize lots of work to revise things and look at what to do.

my own two cents – delegation

I joined that school right after the exam debacle, and I was to teach the leadership and management class. ( I have ten years of hospital middle-management experience.) I did some specific research, and analyzed the existing class syllabus to see what emphasis was being taught. I concluded that we could benefit from beefing up the content on the subject of – delegation.

history of delegation content on NCLEX exam

It turns out that in the mid-nineties, feedback to NCSBN was that new graduates needed to be strong on delegation skills, and NCSBN asked for a higher percentage of the exam to be devoted to this subject area.

three questions

a) if you knew that up to twenty per cent of the NCLEX could be devoted to delegation, wouldn’ t you want to study it more?

b) if you knew that NCSBN did a specific fortyone-page paper on the ins and outs of delegation, wouldn’t you want to know what was in it?


c) if NCSBN developed a teaching program on delegation, wouldn’t you want to study that? These are the same folks who said that delegation is an issue, after all. )

My answer to all three was yes. Most textbooks of nursing management cover delegation, but they tend to limit it to four or five pages; my advice is to find the source document from NCSBN and to download the whole thing ( it’s free). Study it from there.

how is your assertiveness skill today?

One of the best and most cogent points made by NCSBN in their paper is that the best rule making related to delegation ( having the best rules in place) is not helpful unless the nurses who are supposed to use the rules for patient care also possess the interpersonal skills to deal with conflict resolution and problemsolving. A surprising amount of the forty-one pages is devoted to ways to communicate effectively in situations where a licensed person is directing unlicensed personnel. The rules are designed to support the RN but if the RN does not assert themselves it’s a problem. Being assertive is not the same as sparking a confrontation. ( see note below – Thanks JPA!) nurses are sometimes so afraid of confrontationthat they won’t speak up even when warranted.

NCSBN even gives you role play scenarios to use in class when you teach this.

final words

in the previous blog entry I wrote about summer internships and being a good follower.  the paper on interpersonal skills applies to you right now as a student nurse and if you communicate effectively you will stand out from the crowd. start reviewing it now and you will be that much further ahead.



Filed under NCLEX, nursing education, Uncategorized

3 responses to “how to boost your NCLEX score by twenty per cent

  1. jpacklin

    Just a tip re: delegation and NCLEX I learned from Kaplan; if confrontation is one of the answer choices, rule it out immediately, it’s never the correct answer.

  2. Pingback: How to teach delegation and the Nurse Practice Act, part 1 dec 29 2013 | Nursing in Hawaii

This blog is actively moderated. Offensive, insulting or boorish comments will not be approved. On the other hand, show me a sense of humor and I will follow you anywhere....

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s